Achilles Tendon – Recovery from Surgery Diary
This Diary records the results I obtain as I recover from a fully ruptured Achilles tendon injury which required surgery in order to be re-attached. Up to the 20th of July 2010 the entries tend to be written as more of short essays that cover overall concepts as well as specifics. From the 20th of July onwards they are date-entries with specific points of interest and progress or setback as well as regular entries to explain any update in any specific regimen I undertake that has not been previously explained. In general the earlier entries may seem to be the “least” interesting, but they do have a lot of practical content applicable to this whole injury in general. Pictures and so on appear after the entries from the 6th of July.
The diary will cover everything from initial injury and steps taken to listing various medical conditions, steps I take or plan to take with the recovery process and what methods I use. Specifically, Hypnosis or other methodologies will be detailed wherever possible.
Please remember that I am a trained Sports Hypnotist as well as a Clinical Hypnotist and what may work for me may not work for you. I am not a medical doctor and I cannot prescribe medical advice. The purpose of this diary is simply to:
- Show what is possible
- Record progress and setbacks (hopefully there won’t be any of those!) as they occur so as to provide a time-line of events before and after the choices I make
- Help any persons suffering from a similar situation to know there is indeed hope, as well as a chance for a full and relatively speedy recovery, which is ultimately my aim.
Come to check here often as updates will be regular. As this entry becomes longer and longer I will sub-divide it with title-headings so that a quick scroll down will easily identify for you the section most relevant to you, be it the initial steps to take immediately after injury or the various processes I undertake to heal faster and better at different stages of the recovery process.
Initial Injury – 22 June, 20.20PM, London
The way the injury happened might not be too relevant to most people, but I was personally surprised by it so I include it here in case others had a similar experience and like me, found it strange that most injuries did not happen in such a deceptive fashion.
I was teaching Systema at the Gym and demonstrating a punch with Luis. Basically I stepped forward to punch him and felt something in the back of my right calf which pretty much felt as if someone had taken a full swing of a baseball bat to it.
The one good thing about this particular instant is that I was able to verify for myself that Systema training does indeed act on a level that is deeper than the instinctual reactions we think are pretty much hard-wired into our existence. I turned calmly to see who had kicked me (and crippled me, as I was instantly aware a hit of this nature was debilitating) but the nearest guy was too far away to have done anything. I asked him anyway and he looked at me very confused and said he had not kicked me. I then asked Luis if he had somehow managed to do some weird ninja stunt of invisible action and he also looked at me like I was landed from Mars. At which point I just said “Oh well. In that case I just popped my Achilles tendon.” I was so calm, and my body so relaxed that the guys did not believe me for quite a while and I had to tell them to carry on training while I removed my shoe and so on. Indeed it was obvious the tendon had snapped since there was no actual hard tendon at the back of the leg, just soft “empty” meat. Despite this I could still flex my foot. once again, this is because of Systema, as we have learnt to use all sorts of muscles that most people do not. Even at the hospital later, when they saw this they first told me that it couldn’t be a full rupture. It was. through and through, as confirmed later by my surgeon and as is indeed written on my medical report.
Apparently this type of injury is common in footballers, basket ball players and martial artists. Particularly if they have been doing it most of their life. The actual causes are not medically known exactly. For myself I can say that I firmly believe over-training was the culprit. It is a mistake often made by martial artists in some form or another and I will learn a lot from this period in terms of listening more to my body. Something that it seems I keep learning to do more and more as I get wiser. Wiser, you hear. Old are the dead as my grandfather used to say.
I still walked myself to the upper floor unaided (though slowly and using my right foot as a kind of dead stump to place carefully rather than a foot). I then immediately placed ice packs on it. The boys then helped me walk the rest of the way to the boat I take to go home (about a kilometre walk I think) after which I walked still (aided by Redhead Girl) to a taxi and after that not much walking left. There was little to no swelling, but again, I put this down to the fact that my body has now been trained for several years to react in a way that is very unusual to an injury. Staying relaxed even when taking relatively serious physiological damage undoubtedly helped my injury be less severe from a swelling and blood-clotting point of view.
Initial treatment was to put me in a cast and send me home. I knew it was a full rupture (it didn’t take a genius to diagnose) and I immediately asked for the surgery and was adamant on it despite the usual hospital staff trying to possibly dissuade me (it’s cheaper for them if I remain lame you see, thanks to this all being at the taxpayer’s expense, which me being one of, I’d rather opt for the non-lame option thanks). I tried to be operated immediately but they had no space and told me Thursday morning was the next available time. This is within the suggest 48 hour window during which surgery should be done in order to be most effective. As it happens they did me at about 5pm on Thursday so it was pretty close to the end of that 48 hours.
I was told to keep the leg elevated and i tried to keep it above my heart level as much and as religiously as possible.
I don’t like to take drugs if I can help it and the leg was not really bothering me that much aside form preventing sleep, so I took the pain killers and anti-inflammatories only at night. I did not feel i had much swelling so I didn’t take more during the day.
Surgery 24th June 17.00pm
According to the surgeon the surgery went well. I was in hospital one night and most of the next day and they monitored my heart rate many times. Throughout the period my heart rate was between 63 and 59 except when I first came out of surgery. I couldn’t speak for a few minutes but was fully compos mentis and I saw it was around 80 but the nurse on duty at my bed explained to me this was due to the drugs they pumped into me and in fact a few minutes after I came awake it was back to 60.
The first night I took painkillers as prescribed to sleep, but got no sleep anyway due to noise on the ward as a result of one old man being moved and the ward requiring cleaning after he left.
I drank a lot of fluid as I was pretty dehydrated by the operation, I estimate probably about 3-4 litres if not more.
Pain medication wore off at about 3 am and they then gave me a blue pill which I honestly thought was a placebo as it had zero effect. I therefore self-hypnotised for pain and sleep and slept a couple of hours before being woken at 6 am.
The blue pill apparently was morphine but I always have had a bad reaction to morphine (in liquid form it just made me drowsy/semi-conscious but did nothing to remove pain and just gave me very unpleasant sensations that I can only describe as a mixture of nausea and quasi-hallucinogenic sensations. it also prevents me from sleeping. The tablet form apparently does nothing at all, unless it really was a placebo.
When the doctors came round in the morning he told me that the surgery went well, that they had a good re-attachment of the tendon and that they had tested it in the theatre before zipping me back up and had achieved nearly 100% mobility. He explained it was necessarily a little shorter since they had to neaten up the frayed ends. I understood it pretty much as a frayed rope that required a little bit of cleaning up of the frayed ends before they could be stitched back together.
Initial Prognosis for Recovery
According to the doctor they had put me in a cast that kept my right foot pointing down (like a ballerina pointing her toes type of position). He explained I would be in this cast for 6 weeks and that every two weeks I would have to come back and have one of the wedges holding my foot removed. After the 6 weeks and the removal of all the wedges (and hence my foot’s return to almost fully horizontal/normal position) I would then be transferred into an air-boot (see images below) for a further 4 weeks. After that physiotherapy would begin.
I asked how long before I would be back to normal and what percentage of use I could expect to retain. He told me about 6 to 9 months before I was really back to full strength, with the emphasis being more on the 9 months for true full strength. The good news is that he said I should eventually recover 100% functionality. he knew i was a martial arts instructor and active and wanted to continue doing what I do, which is why he explained that while I might be able to train lightly after 6 months it would probably be more like 9 before I was truly ready to do the ninja running up walls and what have you.
Secretly I planned to be ready much earlier than that. At the end of November I will be going to Brazil with Redhead Girl, and I fully plan to be able to enjoy my trip, take on Brazilian Ju-Jitsu challenges in my stride and generally run around as much as possible, so my plan is to be as close to 100% in 5 months, which is exactly what I have before the trip.
Initial Recovery June 25th to 6th July
I was in a half-cast tightly kept in place by elastic bandages.
I kept my leg elevated as much as possible and went out of the house only as required in order to go back to the hospital on the 6th. I took drugs to sleep only the first 4 nights then only every other night or so and mostly to sleep. I have always been a very light sleeper and partly insomniac, but I knew I needed to sleep deeply in order to heal well and the first days are critical. I made sure I got good sleep the first week. I also self-hypnotised every night before bed for advanced healing of the tendon, imagining it knitting deeply and strongly and new fibres re-connecting and attaching to each other and mixing in with the permanent stitches in my leg too.
Sometimes I did a milder form of self-hypnosis during the day too. And whenever thinking about the leg I always thought about it in a good way and in a way that felt right to me with respect to the healing. I feel this self-hypnosis was effective and doing its job as I could sense some perception of improvement almost daily.
I also cut out all dairy products from my diet and only ate red meat and lots of fruit and salads which were made quite heroically by my sister for one week and Redhead Girl the following week.
It needs to be pointed out that immediately after the surgery I did NOT have a quiet time at home as I had to deal with a long-standing issue that had finally come to a head with my landlord and solicitors got involved, so I had to prepare a 300 page file and response on a quite stressful matter than had been going on for months despite my best efforts to resolve amicably.
I mention it because it is my belief that such stress cannot be of any aid to the immune system, however, the mental attitude to such situations I feel is critical. Being able to face ANY bad news, eventuality or situation, regardless of your physical ability with a sense that you are going to master it is important. It is difficult to describe the mental attitude. especially to persons not involved in martial arts for a long time, but the best analogy I can make is that it is similar to going into a fight with a physically superior foe whilst already injured. Panicking, feeling it is all unfair, or sorry for yourself or throwing a tantrum in the hope of getting out of it is all a fatal mistake. You need to stay calm, keep your eyes open, realise what you can still do and wait. Do not rush, do not give yourself time to be afraid. Every molecule of your being should be set on the here and now. No projecting in the future or past. Just react in accordance with the situation and ONLY in accordance with the situation, not with your IDEA about the situation.
In fact, I’m writing this on the 21st of July and I still am managing to hold off thoughts of the near future very well. Being in the present in these situations is key. Hypnotise for healing and rest whenever you can. Eat well as much as you can. Cut out bad foods. Do not drink alcohol. Stay focussed. Do what you need to as you need to. you have time. You always have more time than you think you do if you live in the present and deal with reality instead of fantasy. I mention this mental attitude at such length because I feel it is the most important point of a speedy and full recovery from my point of view.
Second Stage of Recovery and Assessment of Initial Recovery
6th July to 13th July
On the 6th of July the first cast was removed and the comment from the nurse at the time was that the doctors who operated on me and put the first cast on obviously “did not trust me”. Apparently the cast I had been wearing for 2 weeks was considered an antiquated and unnecessarily heavy system, only to be used on farm animals and dumb sportsmen that will re-injure themselves easily by trying to go back to full activity too soon. As it happens I was a model patient but the heavy cast had caused me some knee and hip pain due to the weight.
The new cast was far lighter and actually stronger and really a much better option as I also felt it immobilised everything much better. I think of it as manga armour and is built with a special acrylic tape they dip in water and then bandage you with. After 10 minutes or so it becomes rock solid and has to be cut off with a special tool.
Cast-wise this was to a certain extent the best week. I could wiggle my toes easily and I kept the leg elevate easily and due to the reduced weight of the cast did not suffer as much knee or hip pain. Everything was fine for a few days but around the night of the 11th or so the foot and ankle began to hurt/burn. After that trying to go for a “walk” (on crutches) was painful on the leg. I was not sure why, but my sensation was that the total immobilisation, though good in one sense also caused some problems. Muscular atrophy had now begun and a combination of absence of any physical activity in the calf muscles coupled with the leg requiring almost constant elevation to prevent blood clotting and excessive bruising in the surgical scar area meant that as soon as I lowered my leg my toes would turn purple and the aching of the ankle area would begin in earnest. I thought some adjustment was normal and put up with it for 24 hours but after that I returned to the hospital for a check up. They removed the cast and placed me in an air-boot. This was actually way ahead of schedule compared to the original prognosis.
Third Stage of Recovery 13th July to 20th July
The air-boot was supposed to come with 3 wedges placed under the heel in order to continue keeping the foot still pointed ballerina style, but reducing the angle by removal of one wedge every 2 weeks. As a result of my having been in a solid cast only 3 weeks (and the first 2 weeks of that in a partial cast really since it was held in place by heavy bandages rather than plaster of Paris) though three wedges were not enough and I felt the tendon area giving me a sensation of “pulling” to a degree that felt unsafe for me. I therefore asked for an extra wedge. And so it was that on the 13th of July, not quite 3 weeks after surgery I was already in an air-boot. Which compared to the initial prognosis was 3 weeks ahead of schedule.
I do believe I was healing well and possibly faster than normal, but I am also pretty sure that partly this also had to do with the lax attitude of the doctor on duty on that 13th of July. Had I seen the previous doctor I had seen on the 6th I am almost sure he would have request for me to be put into a new full manga-armour cast.
The Air-boot has some advantages and some disadvantages. Here they are:
- It’s removable, which allows you to wash better and easier as well as massage the foot and generally check up on it
- It’s adjustable. Along with a little air-pump you can pressurise the internal parts of the boot to a level of pressure that works for you (generally I tried to keep it relatively strongly compressed when the leg was elevated and at night during sleep at first, and a bit less compressed when going out and about on crutches)
- It makes getting around on crutches easier because you can basically rest/walk the injured leg along the ground, though you still can’t put any/much weight on it, it at least allows you to take the weight of the leg off your other, compensating hip.
- It’s pretty heavy and the trouble with the knee and hips returned quite quickly once using it, so i tended to keep it off for several hours during the day and around the house. Something that heightens the risk of re-injury if you are not careful, because, fall over just once without it and you could re-tear the whole tendon. Not smart. But I am a very careful crutch-acrobat and so far so good.
- Being able to remove it so easily you tend to do so more and this might not help recovery as compression generally aids the healing of wounds and promotes better circulation.
All-in-all though, I prefer the air-boot to the manga armour. The ideal though in my opinion would be an individually moulded manga-armour specific for my leg, with some smart air-pockets in it (better designed than the ones in the air-boot, as they are essentially all linked with each other, while I feel separate air-pockets would be better as it would allow more precise control of where and how much pressure you could apply to specific areas.
The ability to remove the boot allowed me to also check up on the surgical cut and see how it was healing as well as to perform gentle massages on the foot to improve circulation and reduce the bruising which was still evident on the 18th of July as can be seen in the picture below.
Close up of the surgical scar is below. The stitching is not exactly top quality and in my opinion only a bit better than what I personally would do to a sausage, but I am hopeful that the internal stitching was firstly done by a different (and better) surgeon and secondly that my natural mutant healing factor will make it so that it really doesn’t matter. I don’t care at all about scarring (if I did I would need a lot counselling really, given that I have many scars from an erh-hem..active/stupid lifestyle) but obviously if the stitching is of better quality it promotes the joining of the cut meat a lot easier and faster as well as structurally stronger.
The stitching was of the “melt-away-by-itself” variety so there was nothing for me to remove here.
19th of July: I removed one of the 4 wedges or inserts under the heel and have no problems adjusting to the new angle. I also try to make the foot get used to being on the floor, being touched and gently massaged if possible so as to ensure correct neurological recovery.
20th of July (Progress): The bruising was nearly completely gone after one session of self-hypnosis and 2 hours of induced sleep without a boot on. Please note that I do NOT recommend sleeping without a cast on for ANY length of time to anyone. Most normal people are unaware of movements they make in their sleep and you can cause yourself serious damage and easily re-injure yourself while asleep if you do not use the protective cast to immobilise the foot. I have a weird ability, developed in part as a result of my upbringing, training and mental disciplines that allows me to sleep in a specific level of sleep where my body movements are still registering to me, so I can do this safely but it is not a skill you can learn in a week or even ten really and it may not even be transferable, so please do not do this on the basis of what you read here. You are ultimately the only person that can decide what is best for you, but as I said at the beginning, my approach is really just the way I choose to attack this problem. It might be counter-productive and even dangerous for you to try and emulate my choices here.
From here on, I plan to make my entries relatively short and relatively frequent.
23 and 24th of July (Setback): Having impacted joints in my right foot from my days in karate training means that I have considerable scar tissue in and around the big toe. There is an impacted joint problem on the first joint of the big toe, and this gives some mild discomfort, mostly in terms of me feeling like I need to “click” the toe by curling my toes intensely, something I cannot do obviously due to the tendon still being in the healing stages. The larger problem is on the second joint of the big toe, which is effectively referred to as the “ball” of your foot. This joint was impacted more severely and years of barefoot training also contributed to my feet getting peeled on that spot brutally and forming scar tissue directly over the impacted joint. This of course was all the result of my own stupidity. If you have soft-skinned feet and you end up having red-raw holes in the soles of your feet, there is really not much sense in continuing “past the pain” in good samurai fashion. You just injure yourself for no good reason and although it might make you mentally tough, there are better ways of doing this. Systema being my preferred choice. Anyway, with respect to the healing of my tendon surgery, this means the second joint is very uncomfortable and with progressive muscular atrophy the scar tissue is now much more prominent meaning the situation is basically:
thickened skin—>scar tissue—>impacted joint—>bone structure
Not fun when you put your foot down and you feel uncomfortable because instead of a “foot” making contact with the floor, it feels as if you have a half-inch of dead matter inside your foot making contact with the floor and throwing your natural “normal” foot balance off as if you were stepping on a small hockey puck.
I am contemplating getting some specific needle physiotherapy done as this had worked years before to actually remove a point of bone on my heel bone (also caused from an injury in karate training). The problem is that the physiotherapist doing this needs to basically be a mixture between a magician, an artist and a surgeon. In other words…hard to find. I have one prospect, but the thing about needles is..once they are in…their work or damage is done. Also..the process is certainly not pain free and neurologically I am trying to not associate pain with this foot as much as I can avoid doing so. As a result, this entry probably goes under the heading of “setback”. But if I find a solution, it means I will have solved the old scar tissue, so long-term it might be a good thing. As a result I have increased the daily wiggling of toes and augmented it with small ankle movements. I try to ensure the movements are only as far as I can go while keeping them smooth. When it starts to get “jerky” or twitchy in nature due to my weakened muscles and or damaged tendon, or as soon as I develop any mild discomfort in the scar area, I stop the exercise. In fact I try to not have it get to that point. I just try to take it to the point where it feels like the tendon is “pulling” slightly but not for a long time or in any way painfully so.
25th July (Progress): I removed the second wedge from the Moon-Boot, then went to sleep. On waking up, I removed the boot as I had some minor discomfort (this is not unusual as I generally tend to slightly over-pressurize the boot a bit during sleep to promote compression healing) and made an inadvertent movement that put a tiny bit of weight on my right leg, something that would have made my hair stand on end long before it got painful just the day before, but I was surprised to discover I was comfortable with the movement. No pain or discomfort or any “fear of the body” was experienced.
This just reinforced for me how important mental attitude is to ensuring the body is sending the right neurological signals to the damaged tissue. It is a principle of Systema training that an injury can continue to send erroneous signals to the brain long after the body has healed. One needs to re-wire the nervous system to keep up with the physical healing that has taken place.
If this were a broken bone (something I unfortunately have quite a bit of experience with) I would know I am well on my way to recovery already. This being a tendon however, I have been trying to find out about tendon growth rates and expected time-lapse before actual structural strength is restored based on clinical studies but so far I have been unable to find anything very useful. I am therefore going by the way the external scar is healing as this is an overall good indicator of tissue repair, though I am aware that tendons do not heal in the same way as general muscle tissue and thus have different requirements. Even so, it is a start. The picture below shows the rather dramatic improvement on the surgical scar just a week later.
The purple line is basically a fresh well-healed scar. The places where some scabbing remains is essentially the areas where the guy who stitched me up treated the closing of the wound more like a salami procedure instead of his daughter’s delicate face, but overall, apart from at the bottom, closest to the heel, where there is a tiny section of dog’s breakfast type work, the surgical opening has now essentially sealed well. Tendons take longer to heal than muscle tissue but even so, some structural integrity must now be in place. If I manage to continue my own form of mild physiotherapy, it should essentially help. As of today I also have a perceptible increase in foot mobility and can curl my toes to about 65% of a full “foot-fist” without any discomfort. Shortly past that though refers some (mild) pain directly to the area of tendon surgery so I will not push past this. Also, as there have been a lot of gains literally from one day to the next I think it’s important not to “push” the new-found mobility for a couple of days.
Overall, this has been a surprising and very positive day and it has reinforced for me that my mental approach is correct.
26 July: I built a super-thick Flip-Flop so that when wearing my air-cast boot I could be at roughly the same height on both feet, promoting the early beginnings of some mild form of physio-therapy when using the crutches to walk, by being more able to place a tiny load on the injured leg and at least making the motions of walking if not actually putting much weight at all on the leg. My efforts are definitely worthy of appearing on a site like There-I-Fixed-it, and in fact nearly got me killed because there was a bit too much play between the various pairs of flip-flops I duct-taped together.
My next effort will be more professional, but the duct-tape flip-flop is still ok for getting around the house…as long as I go slowly and carefully.
28 July: Redhead Girl had met this woman who did some “weird” therapy. Not really knowing what it was about I asked her to book me in. As it turns out, the “weird” therapy is actually quite interesting. It’s called BEMER which stands for Bio-Electro-Magnetic-Energy-Regulation. Basically it is one of several Pulsed Electro-Magnetic Field devices available. It consists of a mat you lie on for from 8 to 20 minutes and a smaller mat or device you can apply directly to surgical wounds and so on.
There are different theories on how this stuff works (or not) and I will leave it to you to google your way around it. For myself, I definitely felt it improves something. they describe in their literature how it improves micro-circulation and I understand how this would definitely promote faster healing of post-operative wounds. I have read some stellar reviews and at least one that was far from promising, however…even the bad review admitted that at least some patients react well to treatment with it. The main difference seemed to be with chemically allergic people, that is persons who are allergic to a large number of chemicals, or at least very sensitive to them. personally I have a different theory on why it works on some and not on others. I am very familiar with different trance states and how to go into them, and I noticed several things. Some of the descriptions that follow may be scoffed at by sceptics who do not believe certain abilities are possible, however I would like to refer such persons to a book by Daniel Goleman called Destructive Emotions where he refers to various lab-controlled tests done on Tibetan Llamas that prove that even reactive responses thought to be hard-wired to the body at a neurologically completely unconscious and automated response can in fact be controlled by persons that have long experience in meditation and/or specific training. So it’s not voodoo. It’s scientific fact. Check for yourself and don’t take my word for it. Furthermore, I have been able to regulate my own heartbeat and blood-flow for a few years now, having learnt to do this as a result of my Systema training. In fact when teaching certain aspects of Systema I sometimes demonstrate the change of colour in my hands due to blood-flow without any change in external physiology at all, only by mental control of where to direct blood-flow. Several of the people I have trained can attest to this fact as well, so again, not voodoo, just science. Little known perhaps, but no less real because of it. Without further apology for my superhero abilities then:
- You can definitely feel the magnetic pulses in your body and how they are affecting several different things, including your nervous system to some extent, this is in my view essentially almost identical to a certain type of trance that is induced in certain types of hypnosis, with which almost every single modern hypnotist I know of is just not familiar with at all. In fact, I personally believe it is a different form of trance from a hypnotic one all-together, though how to explain this difference would be difficult and practically impossible in a sentence or two.
- Blood flow is definitely affected, increasing overall.
- A kind of heat that I personally associate with my body healing. I was familiar with this process long before I ever learnt Systema, as a result of the many injuries sustained in my years of training in Shotokan Karate. Specific areas of my body where an injury was sustained heated up a lot more than the rest of my body when I was in partial trance or a kind of sleep I learnt to enter into before I knew of Hypnosis that was purely curative more than for resting. Generally this is considered Theta Waves sleep. A deep sleep that allows the body to recover much more than usual for the same time-span.
- An overall trance state is induced by the machine, but ONLY if you have the correct mental attitude to it.
That last point is where I probably lose the sceptics, but so be it. The fact is that our mental state affects our ability to go into the type of trance being discussed here (or indeed any kind of trance). You can hardly go into trance if you’re thinking about your phone-bill in a worried manner for example.
Similarly, if you do not “allow” the induced magnetic field to “take you over” and put you in the right state, you will instead experience some mild irritation, a not insignificant level of anxiety, possibly irritation of the skin due to over-stimulation of the nervous system. I tested this having used the machine several times now and it reacts the same every time.
In order to explain a little more, let me make the example of someone worried about the safety of their child, trying to get into a meditative state. It’s going to be very hard for most people to do so, in fact, probably impossible for most. Now imagine you still have that worrying sense but a machine is trying to force upon you the correct mental state (with corresponding difference in your personal magnetic field). The result is that if you do not “submit” to the machine, the mechanical field will essentially “rub your nerves raw” to some extent or other. I believe this adequately explains why some people do not gain as much from this machine as others.
In any event, several large trials have been run with BEMER machines on a variety of complaints and almost every one have shown some measure of improvement in at least a percentage of the patients. In general the percentage ranges from very small up to 84% that get completely cured or has definite adavntages from the treatment over a period of 6 weeks. Luckily for me, the thing that BEMER machines seem to help the most with are post-operative surgical recovery. So from my point of view…Go BEMER. I actually hired one for a week and am trying to go on it at least twice a day but 3 or 4 times if I can.
If you are interested in trying a session out, keep an eye out on my blog as I plan to do a more specific review of it after my first full week using the machine, but in the meantime, you can find out all about it and go for a trial session (which I think is only £20 if I recall right) here : BEMER Health Centre
I certainly felt a difference even after the first trial session I did at the BEMER Health Centre, which is run by Kathy Geminiani, who is quite passionate about the system (but I told her being an engineer by training I would be brutally sceptical and direct about whether I thought it worked or not). Namely, my right leg basically begins to hurt a bit from the blood pressure as the now atrophied leg does not circulate the blood as well as it used to and a few minutes after having my leg in a non-elevated position this occurs. After the session I sat and talked with Kathy for a good half-hour and had none of this going on. But because I am a super-sceptical guy, I kept in mind the fact that it could all be some kind of weird placebo effect brought on by my own unconsciously putting myself in a trance and doing self-hypnosis (which can obtain similarly “superhuman” results, such as lack of pain, improved strength etc. etc.) It is only after 3 days of experimenting with the system that I can attest that definitely the effect is not just due to my own self-hypnosis (though it helps if you can place yourself in trance easily).
Overall I would definitely recommend using the BEMER system, with the only proviso that you try to get yourself to be clam and in an accepting meditative type of state and allow the machine to “modulate you” without resisting. If you do this it is not unlikely that you may fall asleep or at least enter an altered state which promotes healing, similar to theta wave sleep.
If you are sensitive to many chemicals or are generally a “twitchy”, nervous type of person who doesn’t know how to just relax and go with the ride, you might find it irritating or possibly even uncomfortable or a bit scary. the good news is that there are apparently no side-effects even if you are one of the ones that gets irritated by it and many tests over thousands of people in clinical conditions seem to bear this out quite well enough for even my own general sceptical attitude.
Lastly, in case you are wondering, I am not getting a commission for promoting BEMER or anything like that. I may refer some of my clients in the future to Kathy, if they have issues that I fell might be helped by the BEMER machines, but this is purely because I think this system gives positive results. I also refer clients to colleagues that I feel are going to be better at helping them than I would be, for whatever reason, as ultimately my goal is their betterment, so my giving an overall positive impression of the BEMER system is just my expressing my honest opinion and nothing more than that.
30 July: Way ahead of schedule I have now removed another wedge from my air-cast boot, which leaves me with only one wedge to go. In terms of progress if I manage to sense my foot/leg, healed enough to remove the last wedge in another week it will mean that after 6 weeks of surgery I will not only have removed all the wedges (which is in line with the original prognosis) but also been in an air-cast for 3 weeks, so basically I would be 3 weeks ahead of schedule, which is just what I wanted. I think early next week I will begin to book some hydro-therapy sessions. The sooner mobility is restored to normal, the sooner I can begin to reverse the muscle atrophy.
31st July to 4th August: I continued to use the BEMER system and also taped up my surgical scar a bit to see if I could get the scar tissue minimised. During this time I also used the small BEMER machine on the scar tissue I have on my right foot (see the entry 23-24th July for details) under the second joint of the big toe and I was amazed to see it gave pretty instant results. The whole area, which is basically about one and a half centimetres thick and has a diameter a bit larger than a £2 coin suddenly became soft and able to be manipulated. Later it returned to be a bit harder and I should have massaged this area right away, something that is unfortunately easy for me to do on myself (luckily I have Redhead Girl. I must have been really good in some past lives!). With massage and more BEMER machine (both the full mat as well as the more localised action using the small unit for the foot areas that give me trouble) the scar tissue has been dramatically reduced. Quite honestly I did not think this would be possible in such a short period of time. Overall health of the leg has also improved dramatically in one more important way. The tendon on the right leg, despite having been sawn back together exhibited a quite clear “dent” in it. I worried this meant that only a partial attachment or maybe a bad one had been done because if you take a look at your own healthy Achilles Tendon, it has a smooth, uniform curve all the way up the calf as far as you can feel it. It certainly does not have a “bite” or obvious “dent” in its rise up the leg. Well, after 3 days of me not removing the improvised bandage for the surgical scar, when I removed it today I was very surprised to see that the “dent” had suddenly almost completely filled in. this was a “dent” of about 2 centimetres that was now only a few millimetres across and much shallower. I feel as if the tendon has finally grown in these last 3 days. Whether it is due to the BEMER improving circulation and thus tendon growth or not, I cannot say with absolute certainty, but it may well be. I also have noticed a continuing improvement of the angle at which I am able to support some weight on the injured leg. The only down side so far is that my right leg is so atrophied compared to the left that I can now clearly see the shin bone and feel the other bone of the calf just under the skin at the back. I know that gaining muscle back where you used to have some is easier than building it up from nothing, but Tim Ferris notwithstanding, it’s still going to take more than a month of pretty serious training to begin to get back to some level of normality and that is if I could use the muscles at full strength, which I would be careful not to do given that the last thing I want is to re-injure the tendon.
Overall though I am pleased as I think my own best guess that I should be relatively mobile in 4 months instead of 6 seems to be more or less on track. I have also ordered some materials for use in a few weeks which I will discuss closer to the time, but I basically intend to build myself another partial Manga Armour cast to improve the physiotherapy of my foot in gradual but ever-progressing incremental steps. This will be rather experimental, so really quite dangerous and I cannot advise you to follow suit or copy me. Besides, getting the materials is practically impossible in the UK and I had to order them from the USA.
I will update you on this when and if I decide to take this step.
5th to 7th August: I took a little break from the BEMER machine to see if progress changed and I think I have noticed a bit of a slow-down, but at the same time I also felt my body might need a break from it. I will use it again quite intensively soon and report of the results. One other point of interest, I have discovered, through a friend the concept of Feldenkrais Healing System, which is essentially based on a concept of gentle manipulation by another person. I had already been doing this in essence by being lucky enough to have Redhead Girl massage my foot once in a while, but on the 6th I got her to just move it around gently, twist the ankle, and so on, but just generally move it.
The improvement by the next day is obvious. I should of course have realised this sooner, but having someone else manipulate the foot for you actually helps a lot because unconsciously, if you manipulate it yourself you already know the limit and more importantly the micro-directions and speeds you will move it towards or at. When someone else does it, your limb has no option but be “surprised” to some extent and although the motion should be very gentle and limited to your comfort zones, the fact is that the limb has to basically “surrender” to the manipulations since the various little movements will be whatever they will be. In essence this helps the brain rewire the neurological map of that limb so that areas that would not have been explored (because the signal “injury” still applies to certain spots even after they are physically healed) now get re-connected as functional in the neurological mind-map of the limb.
As a result I went literally from one day to the next from having to use the crutches all the time to now being able to “walk” for very short distances unaided. Admittedly only at a speed and fashion that is exactly like that of a retarded zombie, but without any risk of injury. The ankle still cannot flex very well at all but if I am standing only (i.e. not putting weight on it to walk forwards, but just to hold myself in place, I can now stand unaided. Meaning the foot has basically reached that 90 degree angle used for standing. Walking forwards however entails reducing the angle between the top of the foot and the shin bone to something less than 90 degrees while applying pressure and this my leg is still not able to do and I certainly am not going to force it, but I think it’s coming time soonish (a week? 2 weeks, a few days?) to begin exploring my idea of a half-cast of manga armour to begin enabling me to “walk” without having to flex the ankle joint under 90 degrees, but only flex the toes a little as I step forward. I am not sure how possible it is to build such a cast and even if I get it right I would still have the problem that they are slippery things so certainly not safe, but maybe inside an old shoe it could work. I don’t know how far I will get with this idea because at the moment I still have to buy a good pair of shears that works at cutting the manga armour because otherwise I am not sure how I would get out of it later without a visit to the hospital and their sonic cast-cutter.
Anyway…the good news my gentle readers is that I can once again pee standing up. I think we can all agree that this is an all-important milestone!
8th August: As it was my birthday I was at a local restaurant with some friends from 2pm until about 7pm and when I got home my foot was quite swollen, this having been the longest my leg was not elevated and in a sitting position only. Despite this it returned to normal size quite quickly upon being elevated.
9th August: I tried to remove the last wedge from the Boot but it was pulling just a little too much on the tendon so I left it in. But I did restart the BEMER mat treatment and after a single session the foot could suddenly move a little bit more, making walking for short distances (though still very much like a zombie) more manageable. I was also able to remove the last wedge from the boot. Using only my own injured leg muscles I can now put the foot into a 90 degree angle. The amount of tension on the tendon does make me worry that perhaps some tissue adhesion between the tendon and the muscle in the calf would shorten my range of movement considerably. Redhead Girl worries I am trying to progress too fast, but I know enough about scar-tissue formation to understand that mobility as soon as practically possible after surgery is important. I also understand that mobility is a very different concept from USABLE mobility.
I am not concerned with my leg/foot being able to be useful at the moment, but I am concerned about its range of motion. Some shortening of the range was to be expected but if it remains as it is at present it would essentially make me a partial cripple, and that’s just not good enough. On the other hand, the foot has (with the use of the wedges under the heel) improved in range of motion so there may be more scope for improvement, but as the healing feels pretty solid now, I think some gentle stretching and phsyiotherapy that engages the muscles is now in order. I can now curl my toes (make a foot-fist) almost fully.
10th August: I basically do not use the Robo-cop boot at all any more whilst indoors, but sense that some form of pressure clothing would benefit the healing process. Redhead Girl used to work in the Hotel industry and still has some special type of tights that compress the legs in order to aid with long shifts spent standing all day. I therefore now venture into the partially-transvestite world and wear one of her old compression tights on the injured leg up to just over the knee during sleep.
Apart from being sexy to the more deviant among you, it actually measurably helps and I can feel the difference the next day. the leg is less swollen than usual, and has a much more normal look, being able to retain an overall more normal resemblance to a healthy foot. Whilst before the change in colour and skin-texture was quite evident when going from elevated to sitting or standing, now the foot looks more normal for longer periods of time. Gentle walking, sometimes aided by crutches and sometimes free-standing, also seems to re-activate some of the musculature of the foot and even calf. Although the overall muscle tone is still atrophied and flaccid (an probably is continuing to deteriorate for a while still) there is also some return of tone at a certain level.
11th August: Redhead girl massages the foot some more and it improves the range of movement a little bit (only about a centimetre or so but it’s encouraging). At the end of the day I feel that the Robo-cop boot has now little use except when going outside and I am able to walk around the house, still like a zombie, but a little bit less retarded at least. i keep the sexy tights on the injured leg for most of the day too and this seems to help the overall tone of the foot as well as give an improved sense of support when using the leg to walk unaided by crutches.
12th August: I awake in the middle of the night with the idea of using the wedges in the boot in reverse to help my foot recover the full range of motion. I immediately get up to at 4am and proceed to try this system out and then go on to write for the next 3 hours. The boot still creates hot-spots so after 3 hours it becomes uncomfortable, however the range of motion has definitely increased. I also check the tendon where it has been repaired to see if the “dent” or small “gap” I have described before has increased or changed and discover that it may have increased a millimetre or two. I therefore might be playing right on the edge of healing and causing myself harm here, and although this description probably sounds as if I am taking rash decisions, I am actually happy with my choices and I feel the slight stretching of the tendon I did by use of the boot with a wedge under the ball of my foot instead of the heel (thus increasing the range of motion of the ankle) is necessary because it is also obvious that some tissue adherence between muscle and the healing tendon is also taking place. I will make sure to not walk around unaided over the next few days, so as to ensure that no strain or sudden movement is placed over the tendon. I think the idea of using the wedges under the ball of the foot is good as long as I am careful in using it and give the tendon sufficient time to grow and heal during this period. I am cautiously optimistic that in another 3 months I should be well on my way to full recovery of my pre-injury ability to use the leg, which would be well ahead of schedule so in context I am pretty happy.
13th to 17th August: Improvements are now far more gradual and I was worried that there was too much tissue adherence until I spoke to my friend Uldis who told me his knee surgery took 8 months before he could bend the leg fully so not to rush and risk re-injury. His experience put me much at ease because it allowed me to keep things in perspective, something that I have not been able to do by researching on the net as I have been unable to find a good source of information regarding this injury in certain specific ways that interest me like tissue adherence, tendon growth rates and so on. Nevertheless I do not use the boot or the crutches any more within the home. I still walk like a zombie but not a very retarded one. Most important of all is that muscle atrophy has stopped and even begun to reverse itself. This is not just my impression because Redhead Girl noticed it too without any kind of prompting from me.
I also achieved another milestone today (17th) by taking my first shower standing up again. I can also put pants on now from standing as long as I have a wall or something to lean on. I also am aware that this is perhaps the most dangerous time. My new-found mobility could be the end of me if I do not take extra care to make sure I don’t do something stupid or make an inadvertent movement.
24th August: (60 days from surgery) — I went for a check-up and they were pretty impressed that I was walking around using the crutches only to support me over long distances. I was given some exercises to do, which consisted of stuff I was already doing: wiggle toes, walk the foot/leg forward by using only the toes to pull it along (while you sit in a chair), and do gentle squats with your back to a wall and only going as low as is comfortable for the foot. They also gave me a rubberised band to use when doing exercises with the foot. I had been wanting to get one of these for several weeks already but they were hard to find, and I finally got some on the same day as the lady at the hospital giving me a free one anyway. They also suggested I should still be in a cast (which I am not going back to!) but also made one good suggestion and that was to use some kind of spongy material in the heel of my shoe. I used neoprene from an old knee guard I had lying around but those gel-like things ladies use in their high-heel shoes work well too. I can now basically walk around the house without crutches. I am being very careful especially when tired or first thing in the morning to warm the ankle and foot up gradually so as not to cause any sudden unexpected movements for the leg.
26th August: During the night my right ankle/foot had a sudden twitch/release, like a strong and involuntary release of tension, I am a light sleeper and these days even more so particularly concerning the leg, so I felt it and woke fully but I was not worried. It had felt like a “good” little jerk. On waking the foot’s mobility has definitely increased. There has also been a dramatic improvement from about the 20th of August due to the BEMER system I have been using, but I will post a separate post on that because it really did make a big difference, and it deserves more exposure.
15th September: I went for an MRI scan on Sunday (the 12th) and the oddest thing happened. As it was a previously scheduled scan for another body part, it had to be cancelled due to my surgery of the Achilles tendon. When I re-scheduled it I had to again see a doctor and I asked if I could have one on the foot as well since I was going anyway. They approved it and I then was very efficiently processed, having two scans back to back. Now I really am not sure how to explain this, because medically it has no explanation, but while I was in the MRI machine I could actually FEEL it affecting me and particularly my leg. When I got home I was a strange kind of “sick”. I continued to fall asleep and was completely exhausted, basically unable to do anything be it physical or mental. I also felt a weird kind of sensation throughout my body, I really can’t describe it in any meaningful way, other than it felt as if my magnetic field (aura to some people) had been peeled back, cleaned, re-shuffled and then put back in place. Yes I am aware of how utterly unscientific that description sounds, but it honestly is the best I can do.
The point however is that I was not worried about this at all. The oddness felt reassuring, as if my body knew it was all for a good cause. The thing is that late in the night, the ankle suddenly had an again visibly and even more importantly, internally sensed, much bigger range of movement. The fact it sort of happened instantaneously was very strange. It basically made the difference so I could almost walk normally from one minute before when I was still very zombie like.
Then today I again had a similar occurrence. My ankle just suddenly “released” and the right foot almost feels normal again, the main discomfort or lack of normality in it being mostly a result of the atrophied muscle-tone when compared to the other leg, which though not as pronounced as it was a few weeks ago is still not on par with the left leg. The release was again so marked and so sudden that it actually worried me and I thought possibly I had damaged something. It has taken me a few hours to verify that in fact the only odd-feeling comes from the fact that my foot is no longer used to being so mobile (I now am almost at the same level of mobility as the healthy left foot, I would say at least 80% in the worst case, and probably more like 85 or even 90%, the only difference being in structural strength due to the muscle atrophy rather than range of movement). The left leg instead definitely feels quite tired and I wonder if the sudden release is also a way my body is trying to make up for the excess stress the left leg has been carrying these past two and a half months.
My personal prognosis is that as long as I don’t screw something up, I may actually be back to full strength certainly by the 6 month mark, which in view of all the research I have done since would be nothing short of miraculous (I have yet to come across a single incidence of full recovery in 6 months. In fact full recovery seems to be something not really on the menu). But at this rate, again unless something should go wrong, I think I will be certainly fit enough to take on Brazilian Ju-jitsu guys in time for my wedding!