On Tuesday we had an appointment with Dr. Hansen (Keith did one of his rotations with him) for the pre-op and consult. We read the MRI results which said that he had a "near complete rupture" of the Achilles Tendon. Dr. Hansen and Dr. Bangart both agree that it was indeed "complete."
Apparently Elliot has an extra string-like tendon (or maybe ligament) by his Achilles that not everyone has (he's always been an over-achiever) that is making it possible for him to still move his foot and walk on it. Otherwise, he'd not be able to walk on it at all. Dr. Hansen did an ultrasound of his ankle and you can totally see the space in which there should be a tendon and there is nothing. I can't even see the extra tendon they said he had, but they said it was there.
He has just a little bruising that started yesterday and even the doctor was surprised at how very little swelling he has. Just looking at it, I can't see any swelling, but feeling the ankle areas I can tell.
Dr. Hansen described the ruptured tendon as mop ends dangling inside his leg. The picture I saw looked more like spaghetti . . . both undesirable conditions for an Achilles tendon.
I'm thinking of spray painting the boot gold and red so Elliot can be Ironman for Halloween.
The 3 options for repairing the Achilles Tendon:1) Do nothing and see if the spaghetti-ish shards of tendon will heal on their own. Most likely have a floppy foot forever.
2) Series Casting: Putting a cast on with toes pointed down like a ballerina for 4 weeks and hope the tendons find their way back to each other, taking the cast off and changing angle and recasting for 4 weeks, taking the cast off and changing angle and recasting for 4 weeks, possible repeat . . . takes forever, highly likely to re-rupture, usually only done on old people who aren't very active. Not suggested for a 30-something guy who is as active as Elliot.
3) Surgery: sewing/braiding the tendon back together. This is the most suggested option because they can actually see what's going on in there and make the tendon stronger. Re-rupture is unlikely.
Elliot is scheduled to have surgery to repair the Achilles tendon tomorrow afternoon at 1:00 at a surgery center near the hospital. It's only supposed to take 45-60 minutes to complete the procedure and then I can take him home after recovery. Dr. Hansen said that he braids the tendon together to make it stronger and then grafts human heart tissue around it or near it or makes some sort of shaft to lubricate the tendon. He'll be in a splint for 7-10 days and then it'll be casted with his toes pointing down like a ballerina for about 3 weeks. After that, he'll be able to wear the giant robot boot he's been wearing this week. The only thing he's really concerned about is that he has to take baths instead of showers and that I have to drive him everywhere for a month. I'm concerned about the stinky cast and my sensitive sniffer.
But don't worry everyone, Elliot is fine and will only be getting this attention for a few short weeks after which it can transfer back to me real quick-like. True to my historically poor caretaking abilities (refer to the staph infection of 2001, Natalie Service), I can't stop making jokes about this whole thing. I wish someone was here to laugh at them with me.
Elliot had a blessing tonight and though we aren't concerned about the surgery or it's outcome, Elliot is really hoping for a recovery miracle, even if it's just for a few hours, for Friday so he can conduct the funeral of one of our sweet ward members who passed away on Monday evening. Also, he has to speak on Sunday for Easter.
I really hope coming out of anesthesia is Youtube-worthy!
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