Hello and welcome back to my blog. This post is for the second Action Project in the STEAM class, Cure. In this class we have learned about different kinds of treatments and medications. Because of the current global pandemic, we were not able to have someone come into the building and teach us about CPR. However, we were able to go through an online course that taught us about it and how to deal with emergency situations. In regular times we would be able to get CPR certified but that can wait for now. While learning about different medications, we talked about their functions and what each medication's designated purpose is such as pain relievers and how they interfere with pain messages sent to the brain so your body doesn't register pain in a certain area. For this project we had to create a patient with some illness or injury and develop a patient profile in a medical folder or other medium. This profile is shown below as if I were a doctor giving information to my patient. Please enjoy.
Patient Name: Grant Sullivan
Sex: Male
Race: White
Age: 16
Medical History: The patient is otherwise healthy. Has no previous record of major injuries such as fractures or breaks. Additionally, he has been mainly healthy in terms of illness aside from the cold and a mild flu. His family members are also in good health. Grant’s reason for medical attention is not found in either parents but the father has occasional, mild pain in the lower legs.
Lifestyle: Grant is a high school student who is regularly active. His main forms of exercise are running and biking. Has an average diet for someone of that age who is generally active. He runs frequently but not every day and bikes from time to time.
Reason for Medical Examination: Grant has been experiencing pain in his Achilles tendon shortly after running. The pain begins above the heel and walking can be difficult. He believes he has some form of Achilles tendinitis and is afraid of damaging the tendon further after continuous exercise. He knows his footing when running is somewhat off-center and being at his age, can develop noninsertional Achilles tendinitis. He recently started wearing an ankle brace while running but the pain has not decreased with the exception of when he ices the tendon immediately after exercise. The patient is concerned about rupturing his Achilles which will put him off of exercising for a while.
Diagnosis: After examination the patient has been diagnosed with noninsertional Achilles tendinitis. Noninsertional Achilles tendinitis is when the fibers in the middle portion of the tendon start to break down and swell. This is more common in younger people. There is still a possibility of Grant having insertional Achilles tendinitis which is when the tendon attaches or is inserted into the heel bone. Luckily, this was detected early so Grant has not fully experienced noninsertional tendinitis. Swelling in the tendon has only just begun and degeneration of the tendon is minimal.
Treatments: The following treatment options have been suggested. The majority of these should be beneficial for the early care of noninsertional Achilles tendinitis. They have been ranked in order of urgency for the current situation.
1. Home Remedy - The self-care strategy, often referred to by the acronym R.I.C.E. can be effective for treatment soon after the injury.
2. Medication - Medication can be used during the use of the home remedy if needed. Over the counter pain and anti-inflammatory medication can be a treatment option. If they aren’t enough a doctor can prescribe stronger medication that may help. There is no initial drawback besides fluoroquinolone antibiotics which will increase the risk of Achilles tendon rupture. Should also be aware if there are any allergic reactions to side effects for different medications. Further research on this method of treatment can be found at: https://www.singlecare.com/conditions/achilles-tendonitis-treatment-and-medications
These methods should be positive towards the healing of the Achilles tendon but if they are not, usage of them should be stopped. Further research on this method of treatment can be found at: https://www.uofmhealth.org/health-library/tr2261 or https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/diagnosis-treatment/drc-20369025
4. Surgery - More of a final option in the case where other treatment options do not work. Surgery is required if there is an Achilles rupture. There are a few surgical methods that may be recommended.
Surgery comes with complications. Although uncommon, infections, difficulty in wound healing and nerve damage are possible. Moderate to severe pain is most common in patients following surgery. Full recovery can be from a few weeks to a few months and rehabilitation can be an important step. Further research on this method of treatment can be found at: https://orthoinfo.aaos.org/en/diseases--conditions/achilles-tendinitis/
Recommendation: For immediate treatment, trying the R.I.C.E. method first and some pain medication is advised. This strategy will limit the swelling and further damaging of the Achilles tendon to prevent any need for surgery and possible physical therapy. The R.I.C.E. method does not have many risks associated with it besides what can happen if each step is not followed properly. Although resting may require taking time off from physical activity, it is better to have good practice for relief and the ability to improve exercise habits.
Sex: Male
Race: White
Age: 16
Medical History: The patient is otherwise healthy. Has no previous record of major injuries such as fractures or breaks. Additionally, he has been mainly healthy in terms of illness aside from the cold and a mild flu. His family members are also in good health. Grant’s reason for medical attention is not found in either parents but the father has occasional, mild pain in the lower legs.
Lifestyle: Grant is a high school student who is regularly active. His main forms of exercise are running and biking. Has an average diet for someone of that age who is generally active. He runs frequently but not every day and bikes from time to time.
Reason for Medical Examination: Grant has been experiencing pain in his Achilles tendon shortly after running. The pain begins above the heel and walking can be difficult. He believes he has some form of Achilles tendinitis and is afraid of damaging the tendon further after continuous exercise. He knows his footing when running is somewhat off-center and being at his age, can develop noninsertional Achilles tendinitis. He recently started wearing an ankle brace while running but the pain has not decreased with the exception of when he ices the tendon immediately after exercise. The patient is concerned about rupturing his Achilles which will put him off of exercising for a while.
Diagnosis: After examination the patient has been diagnosed with noninsertional Achilles tendinitis. Noninsertional Achilles tendinitis is when the fibers in the middle portion of the tendon start to break down and swell. This is more common in younger people. There is still a possibility of Grant having insertional Achilles tendinitis which is when the tendon attaches or is inserted into the heel bone. Luckily, this was detected early so Grant has not fully experienced noninsertional tendinitis. Swelling in the tendon has only just begun and degeneration of the tendon is minimal.
Treatments: The following treatment options have been suggested. The majority of these should be beneficial for the early care of noninsertional Achilles tendinitis. They have been ranked in order of urgency for the current situation.
1. Home Remedy - The self-care strategy, often referred to by the acronym R.I.C.E. can be effective for treatment soon after the injury.
Rest: Keep pressure off the tendon for one to two days so it can heal faster.
Ice: Wrap ice covered in a cloth against the skin on the tendon. Hold for around 10 to 20 minutes and then let the tendon warm up again. The ice should help the swelling go down quicker.
Compression: Wrap a bandage or athletic tape around the tendon to compress the injury and keep the tendon from swelling too much. Don’t wrap too tightly so blood can still flow smoothly. Wearing an ankle brace is also an option if moving around with a healing or slightly damaged tendon is necessary.
Elevation: Keep foot above the level of the chest so the blood returns to the heart and keeps the swelling down.
Further research on this method of treatment can be found at: https://www.uofmhealth.org/health-library/tw4354spec
2. Medication - Medication can be used during the use of the home remedy if needed. Over the counter pain and anti-inflammatory medication can be a treatment option. If they aren’t enough a doctor can prescribe stronger medication that may help. There is no initial drawback besides fluoroquinolone antibiotics which will increase the risk of Achilles tendon rupture. Should also be aware if there are any allergic reactions to side effects for different medications. Further research on this method of treatment can be found at: https://www.singlecare.com/conditions/achilles-tendonitis-treatment-and-medications
3. Physical Therapy - Physical therapy can be helpful with treating Achilles tendinitis. Therapy has been proven to work better for noninsertional tendinitis. A therapist may recommend the following.
Exercises: Specific stretching and strengthening exercises will be prescribed. These exercises will promote healing and strengthening of the Achilles tendon and the supporting structures. One type of strengthening exercise is called “eccentric” strengthening. This involves a slow let down of weight after raising it.
Orthotic devices: Shoe inserts or wedges that slightly elevate the heel can relieve strain on the tendon. They will also provide cushion which can lessen the amount of pressure exerted on the tendon.
These methods should be positive towards the healing of the Achilles tendon but if they are not, usage of them should be stopped. Further research on this method of treatment can be found at: https://www.uofmhealth.org/health-library/tr2261 or https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/diagnosis-treatment/drc-20369025
4. Surgery - More of a final option in the case where other treatment options do not work. Surgery is required if there is an Achilles rupture. There are a few surgical methods that may be recommended.
Open Repair: An incision is made to open the leg above the heel bone. The two sides of the ruptured tendon are sewed together and the incision is closed.
Gastrocnemius recession: A surgical lengthening of the calf. One of the two muscles that form the calf is lengthened to increase the motion of the ankle. This procedure can have some complications such as nerve damage.
Debridement and Repair: This procedure may be offered if the tendon has less than 50% damage to it. The damaged part of the Achilles tendon is removed and the remaining pieces are repaired with stitches. For insertional tendinitis, the bone spur is removed and the use of metal or plastic anchors may be required to help hold the Achilles tendon to the heel bone.
Debridement with tendon transfer: This procedure may be offered if the tendon has greater than 50% damage to it. When more than 50% of the tendon is not healthy and needs to be removed, the remaining portion of the tendon will not be strong enough to function by itself. This calls for an Achilles tendon transfer to be performed which moves a tendon in the big toe to the heel bone and adds strength to the damaged Achilles tendon.
Surgery comes with complications. Although uncommon, infections, difficulty in wound healing and nerve damage are possible. Moderate to severe pain is most common in patients following surgery. Full recovery can be from a few weeks to a few months and rehabilitation can be an important step. Further research on this method of treatment can be found at: https://orthoinfo.aaos.org/en/diseases--conditions/achilles-tendinitis/
Recommendation: For immediate treatment, trying the R.I.C.E. method first and some pain medication is advised. This strategy will limit the swelling and further damaging of the Achilles tendon to prevent any need for surgery and possible physical therapy. The R.I.C.E. method does not have many risks associated with it besides what can happen if each step is not followed properly. Although resting may require taking time off from physical activity, it is better to have good practice for relief and the ability to improve exercise habits.
Work Cited:
"Achilles Tendinitis." Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/achilles-tendinitis/diagnosis-treatment/drc-20369025, Accessed 9 June 2021
"Achilles Tendinitis." OrthInfo, https://orthoinfo.aaos.org/en/diseases--conditions/achilles-tendinitis/, Accessed 9 June 2021
"Achilles Tendon Repair Surgery." John Hopkins Medicine, https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/achilles-tendon-repair-surgery, Accessed 9 June 2021
"Achilles Tendonitis Treatments and Medications." SingleCare, https://www.singlecare.com/conditions/achilles-tendonitis-treatment-and-medications, Accessed 9 June 2021
"Achilles Tendon Injury: Physical Therapy and Rehab." Michigan Medicine, https://www.uofmhealth.org/health-library/tr2261, Accessed 9 June 2021
Badii, Chitra. "Achilles Tendonitis." Healthline, https://www.healthline.com/health/achilles-tendinitis, Accessed 9 June 2021
"Rest, Ice, Compression, and Elevation (RICE)." Michigan Medicine, https://www.uofmhealth.org/health-library/tw4354spec, Accessed 9 June 2021
I hope you enjoyed reading my medical folder. This project marks the end of my sophomore year in high school. I have added many new projects to this portfolio over the school year and I had a lot of fun making them. Thank you for reading through these and possibly keeping up with the posts. This project was very meaningful to me because I have had Achilles tendinitis and being able to do some research on it and create a little story was very fun. I have learned so much in this project, from this term, and the whole year. Thank you again and I hope to see you in the next post.
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