Ankle surgery, take 2

ankle fusion surgery

Twelve days ago I had ankle fusion surgery, adding to the long saga of my trimalleolar fracture back in November of 2015. When I finally took myself to a new orthopedic doctor last fall, I was told the metal in my ankle was perfectly wonderful, doing its job, and was likely only 15% of my pain. That was the good news; the bad news was that my cartilage in my ankle was basically destroyed and the pain was from bone-on-bone rubbing… scraping… grinding…

So! I’m spending the minimum 2 weeks with this view (above and below) and the rest of the summer off my foot/ankle/lower leg. Once released from constantly elevating my ankle I have a knee scooter to use, along with my trusty yard sale walker and an old wheelchair. But no walking allowed for three months! Let’s get this ankle thoroughly fused and let go of some chronic pain, shall we?

IMG_20190617_084344025_HDR

 

This is my bullet journal

  1. Three years ago today was when I misstepped, broke my ankle three different ways, and propelled myself into a new trajectory of life.  So… crappy breakiversary to me!
  2. I noticed new/different pain about 7 months into my metal-infused life, so I called the clinic. My surgeon had moved; his replacement told me it was too soon to do anything about removing metal (true) and the placement of all pins, plates, and screws was still in perfect form. The proof was in the X-ray. Tramadol is not my friend, so I was left with tears of frustration and chronic pain.
  3. I saw a new orthopedic doctor a few weeks ago. It wasn’t just my imagination that the pain was getting worse! While the metal is still in perfect form (kudos to Dr. M), the cartilage above my heel is nearly useless now, and I have a large bone spur on the front of my ankle.  The new X-ray isn’t pretty so I’ll leave it to your imagination.  Since it’s too soon (according to Dr. B) to talk ankle replacement, I’ve been cast for a serious ankle brace.
  4. Dr. B told me the metal was only about 15% of my pain; the rest is being caused by the grinding of the bones together. I’m trusting that he’s right about this and that the ankle brace will bring about relief by holding things in place.
  5. I’m obviously now a woman of a certain age and at least half of my topics of conversation are about health concerns.  If you take cholesterol medication, that can raise your blood sugar readings, which might then take you from pre- or borderline diabetes into Type 2.  And if you are stressed in the clinic, your blood pressure will be elevated; if you take BP readings at home with a smaller-than-you-need cuff, you will get false high readings, and then you end up on BP medication as well. Or maybe they’re not so false because this chronic pain is pretty stressful.  It’s the middle aged version of If You Give A Mouse A Cookie.
  6.  I’ve been trying out a new class at the YMCA.  They use some of the same exercises but it takes place in the lap pool instead of the therapy (warm, 4′ deep) pool. In this new-to-me class, we strap on pool jogging belts and utilize deep water. Standing on a pool noodle in 10 feet of water as if it was a skateboard is a balancing act I can barely manage. I’m getting a better (harder) workout but my ankle is pretty much DONE for the day after this class.  Leaving my job was supposed to get me to the pool more often, and that does seem to be showing success.
  7. October was my first month of being retired (or should I just say “not working”?) but I kept quite busy.  I started the month with a 4-day crafting retreat up north, then had one day at home to do laundry and pack before SuperDad and I drove off for a 2-week trip by ourselves. We visited misty geysers at Yellowstone National Park in the cold for a few days, then headed for Utah’s Dead Horse Point State Park. The weather there was sunny and cold during the daytime; the skies at night were amazing with a visible Milky Way.  I had thought my tent camping days were behind me, but I was wrong. (For trailer news, check out this previous post.)
    The rest of the trip was warmer: we spent several days in Tucson to visit my dad before driving home via Las Vegas. It was really nice to not be in a big hurry to drive home before school started back up; my pain level ratchets up during long car rides despite keeping my ankle elevated, so an 11-hour drive in one day is excruciating.
  8. Las Vegas is much more enjoyable on a Thursday evening without impressionable children than it was on a Friday evening during spring break with the kids! Or perhaps The Strip has tamed down a bit?  We don’t gamble, so this was all about seeing the lights and some of the amazing scenes. Walking through the Venetian, it’s easy to forget you are indoors.  We stayed in a simple place about a 10-minute walk off The Strip so it was fairly quiet.
  9. The annual quilting retreat closed out October and brought me into November. I didn’t get as much accomplished as I had hoped, since I had to take regular breaks to elevate my foot/ankle, but I am close to being done with the quilt for Chomper. Next up: squaring (trimming) the sides and sewing on the binding. I’ll be able to finish it before Christmas.
  10. One of the things I’ve discovered about not going to work most days of the week is that I am often clueless when it comes to knowing what day it is! When I was a SAHM, I knew each day because it was my job to know it; the kids had activities and school buses to catch, and SuperDad had long hours being gone for work. With us both at home and 3 young men coming and going all the time, I lose track of days of the week — at least Monday through Friday. One thing I do know is that Thanksgiving Day here in the USA is coming up in another week. By not fighting pain brain while working, I’ve actually managed to plan the menu, contact those coming to divvy up some of the food assignments, and make a shopping list! This might not seem like a big deal but I recall last year when I had no brain power left for such things.

One year later

dislocated left ankle, one of these things is not like the other

Both legs are stretched out straight, and both feet should be pointed in same direction… but one of these things is NOT like the other…

Today is my “breakiversary” — one year ago, I broke my ankle so severely that people gasp when they see the x-ray of the repair.

K's left ankle x-ray, webshare

The trimalleolar fracture has healed but the metal remains.

Most of the time, I do not need a cane — I keep it in the car for walking on uneven surfaces and for days when I am sore and tired. I can go up and down stairs if there is a sturdy railing.  I do still take the cane with me to the YMCA pool; locker room floors and poolside walking make me nervous. The fear of slipping and falling is stronger than my confidence level.

I’m doing better with pain control these days. I’m wearing compression socks or stockings  which really do help. I’ve learned to rest and elevate in advance of activities, not just after the fact. I’ve discovered that I can have a couple of busy days in a row before I have to take significant time off my feet. I can power through the pain when necessary but the price is twofold: I will have trouble concentrating and thinking clearly, so everything takes longer, and I will pay for it with increased need for subsequent rest. I no longer spend much time with my leg elevated above my heart (unless the ankle is really swollen) but I still prop it up on a spare chair and a pillow at the dining room table and I do spend quite a bit of time at home either on the chaise lounge portion of the sofa or on my bed.

One year ago today I went from mobile to immobilized. What I live with now may be my not-so-happily-ever-after or perhaps it could slowly get a little bit better. But I can walk — and that is more than I was promised one year ago.

Sads and Glads

I’ve got a “glad” and a “sad” to share tonight.

First the sad: I finally had an appointment with an orthopaedic doctor to talk about my continued swelling and pain, and even some new (in past 2 months) pain from my hardware-infused ankle which I broke on 11/13/15 and had repaired on 11/25/15. I thought perhaps some screws had worked themselves out a little bit and getting them removed would help, but NO. Everything looks exactly the same as it did post surgery and the pain is “just” (supposedly) traumatized tissue and irritated nerves. In other words, it’s my new life. Terrific. [insert tearful sarcasm] The doc, who was nearly young enough to be my son, suggested compression stockings — which I will purchase and wear when the weather cools down enough to stop wearing sandals — but he couldn’t suggest any pain relief. I had tears in my eyes when I stopped to chat with his assistant (who remembered me from my long ordeal and many visits over the winter) and she offered sympathy which was nice. Honestly, I wanted to have a good cry and a couple of strong beverages but I had a meeting to prepare for this evening.

Hopefully this is all just for peace of mind (worth it!)

A dime-sized piece removed is small payment for peace of mind.

And for the glad: I hadn’t heard back from the dermatology office about my biopsy results, so I stopped in on my way back to work. The good news is that while the strange spot on my cheek was 2 different things (both common but not usually one on top of the other in the same space) it isn’t cancer. That cheered me up just enough to get through the evening meeting spent with my foot resting on a chair and ankle encased in a cold gel pack. I’ve since come home and had a glass of wine. Now it’s off to bed with a melatonin pill and a wish for decent sleep before going back to work in 10 hours.

Your turn… do you have any sads and glads to share?

High Summer

Summer is going strong here in mid-August. On Saturday there were at least two big events going on within 3 miles of my house: a brewfest of craft beer (of which I was sadly unaware until the final 6 hours) and the annual street fair. After brunch that morning, SuperDad and I headed over to the street fair. I told him he could probably find me near tie-dye. 2012 August 11, Garland Street Fair 011
I adore the bright colors! In another life, I could dress like this on a regular basis.

Before long I had wandered over to the classic car display.

Oldsmobile 1951 Super 88, websized

1951 Oldsmobile “Super 88”

DSCN9851 Old blue Ford, resized

This beauty is owned by a man I know. He was looking forward to driving it to get licorice ice cream after the car show ended.

 

Ford Model A 1929, websized

1929 Ford

When I walked over to take a picture of that orange car my camera announced, “Battery Exhausted” and shut down. At that, we decided it was getting too hot for us on sunny pavement and headed for a free (air conditioned!) show at The Blue Door improv theatre. It was a great way to cool down before heading home.

Now that we’ve finally settled into a pattern, our temperatures hover in the mid-90s during the day (35°C) and generally cool off to 60°F (15°C) at night. Since we don’t have central air conditioning, SuperDad keeps the house relatively cool with strategic use of fans. This works really well unless the air outside is too warm or full of smoke.

DSCN6655 websized

Mt. Spokane sunset, August 2015

Unlike last year, we are blissfully free of smoke-filled skies. The sunsets were beautiful but the air quality was terrible. I’ll take clear skies over breathing bits of ash.

There are always a few days or even weeks when we wish we had A/C — I can’t sleep when it’s 80°F/27°C at midnight — but by late fall even I have forgotten those nights when I cannot sleep because it’s too hot in the house.  For mid-day use on a hot day, we have this awesomeness:

DSCN2594 This is how we stay cool in August

Note the sheet closing off the doorway, the a/c unit* venting up the fireplace flue and draining into the plastic tub on the floor.  (*It’s a dehumidifier as well as an a/c unit.)  Our windows do not open in such a way to accept a/c window units, so this is our one and only solution for summer cooling.

I suppose that technically we could all sleep in the living room on hot nights, but that would be too much family togetherness for me. I don’t even camp in a tent with that many people anymore — a 6-person tent is cozy enough for just the two of us old married folks. I need breathing space!

I’m still a little bummed that I missed out on the Brewers Festival — with tastings from some of my favorite breweries (Bellwether, Icicle  and Iron Goat to name a few) but I can only manage a certain amount of walking in a day before needing to elevate and ice my ankle, and no amount of jonesing for a Second Breakfast, Goatmeal Stout or Dark Persuasion* can change that.  Saturday was my 9-month breakiversary. I’m going to see a doctor on Thursday to ask about continued pain and swelling.

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*Just writing about those 3 draughts of deliciousness made me thirsty! I’m signing off now to get get a drink of water. Happy Monday! 

 

 

 

 

It could be worse…

DSCN2529  Bruised toes, and this is my GOOD foot!Was it just 2 weeks ago I was nursing sore toes on my right foot? Apparently my left foot was jealous because in my sleep I somehow managed to jam or pull or otherwise bruise/sprain the littlest toe on my left foot (my FULF as Barb so succinctly puts it) prior to waking up on Wednesday morning. It’s too ugly to show you a picture, but I can assure you it’s really purple and coordinates nicely with my purple nail polish. (Maybe I do need to take a picture?)  And yes, it hurts.
It’s all adding insult to injury since I’ve also been having additional ankle pain — this time on my outer left ankle. The current suspicion is that the hardware on that side (one long plate, 6 screws) is somehow irritating the more natural parts of me.

I did manage to get out and about last weekend, putting at least 800 miles on the minivan (124,000 and counting) all by myself. My ankle truly hates me for all of that driving. (I’ve been hating my ankle lately, so the feeling is mutual)  On Friday I drove to Seattle for a quick visit with H-J. I got to see the lab where he is working this summer and I took him out to dinner at Ivar’s on Lake Union. It was one of those nights that makes a person love Seattle even if it is crowded: so many boats out on the lake full of happy people, beautiful weather, drawbridges allowing passage for the larger boats, evening glow on the buildings downtown.  After dropping my university student off at his place (college students, please don’t leave your dirty dishes in your room… science experiments belong in the laboratory!) I drove to my friend Annie’s house for 2 nights to celebrate her 50th birthday and recent home purchase.  This was the most relaxing part of the weekend, with little to do but a bit of cleaning, cutting up vegetables, drinking wine, and chatting with old friends while elevating my FULF. 

Is it wrong to high-five friends over mutually crummy injuries? We must be getting old. Next we’ll be talking about fiber supplements! Oh, wait…

Sleeping baby on my chest while mama gets allergy testing

Slightly feverish baby sleeping on my chest. I love him so much!

Sunday morning I slept in a bit, then packed up and drove back across the state, but not home — instead I drove to spend 2 nights with The Author and Little Foot. No new pictures because Mama was getting allergy testing done on Monday morning, baby was feverish and couldn’t go to daycare, and Daddy was out of town at a conference in another state. LF’s other grandma was able to come on Monday afternoon and stay for the week, so she’s still there now. It’s no fun to have a sick baby but the timing is great. The Author works for the university and it would be difficult to take time off right now as they are gearing up for fall courses.

cobalt blue lanyard

My blue lanyard: made it to sell, loved it too much and kept it

Tuesday morning I dropped my DIL off at work (hello, $15 per day parking? No, thank you!) and drove 90 minutes back home straight to work for me, too — only to discover I had left my lanyard with work keys at home. SuperDad to the rescue! He brought my work keys and my lunch to me. I was very grateful. He also went to the store and purchased several gallons of ice cream for the neighborhood block watch party held in our driveway that evening. I had enough time between the end of my work day and the start of the party to ice and elevate for 45 minutes on my bed. My ankle hates me and was badly swollen all day.

I’ve made an appointment (first one I could get, at the earliest time available) for August 18th. I’m hoping for some answers as to why I’m having “new” pain 8 months after surgery. By the time I see my PCM, it will be more than 9 months since injury. Did I mention that my ankle hates me?

The Limping Weather Reporter

 

I’m pleased to report that over the past month I’ve finally gotten over that mental hump and accepted that I’ll always have a certain level of pain. I’m calling it an annoyance factor, and as long as I can keep it to the dull roar of annoyance — by keeping my mind busy with other things — I am able to mostly ignore the pain level. However, when the weather turns stormy or when we sink back into a cycle of cold & rainy days, my ability to ignore the messages being sent from my ankle to my brain is hampered.

I’ve been reading up on why I have more pain when the barometric pressure is lower and/or when it is raining and/or when it is cold. The science behind it is fascinating even though it doesn’t make me hurt any less. I asked my Primary Care Provider if there was something I could take to relieve the pain which would be non-addicting and not harm my kidneys or liver. Basically, I’m out of luck on that front. My PCP did sign the paperwork to extend my temporary handicapped parking placard for the car so I’m grateful for the ability to have that when needed. Some days are better than others.

Joining the local YMCA and using the therapy/exercise pool classes has been helpful. My ankle seems to really benefit from the gentle water pressure. I tried walking in the lazy river (one local branch of the Y has an indoor lazy river) but the current causes the water to whirlpool and eddy, and while I hope to someday benefit from the extra work it provides for my ankle muscles, at this stage of the game it only causes major pain. (It’s one o’clock in the morning; do you know where your Percocet is?) The learning curve is real, people.

I’m also still going to physical therapy on a weekly basis. It took 30 visits but I finally made it to “lacking zero” — also known as being able to flex my foot far enough to create a 90 degree angle with my leg; this is what most people would consider normal without any effort at all, but I have to work to get there and work even more to stay there. I was really stiff and feeling pain on Sunday and it had nothing to do with the weather, unless hot & sunny days can cause pain and stiffness. I don’t use them all the time but I continue to keep Ziploc gallon-sized bags of frozen peas at hand for times such as this.

I don’t need the cane in my own house although I’m still unsteady when I first get up in the morning, or when I’m stiff (see above) but I continue to use the cane in public;  it keeps small children and hurrying adults from bumping into me and I need it to navigate flights of stairs and uneven walking surfaces. I do still need to work on not limping.  The limp is a symptom of favoring my left ankle instead of making it work 100%. I know it’s a slippery slope from a limp to back and hip troubles but it’s so hard to remember to really focus on not limping, especially when I’m tired or hurting (or both).

Monday, June 13th will mark my 7-month breakiversary. I wish I had less swelling at the end of the day  and of course I would prefer to not have any pain at all, but all things considered, I’m doing well, slowly ramping up activities and learning to live with my new normal.

 

So for today, I am thankful for frozen veggie ice packs, a cane with a padded handle, handicap parking placards, physical therapists, good water pressure in therapy pools, and pain medications to take when needed.

What are you thankful for today? 

This is what victory looks like

I stayed in bed Friday morning in a final effort to get the excessive swelling to go down. It worked! Here’s my view at noon on Friday:

DSCN7590  3 months plus 1 day post-surgery, cropped to 4x6

Three months + one day post surgery for a trimalleolar fracture in my left ankle

The swelling from last weekend’s activity was beginning to worry me; it still looked pretty bad on Thursday night. I will be more careful in the future about remembering to take the time to rest and elevate my ankle.  At some point, I hope to remove the nail polish from mid-October and apply a fresh coat of color — but that requires more contortion than I’m willing to provide right now.

In an effort to keep from swelling up again, I indulged in only a few hours of very mild activity on Friday afternoon:  I mixed up, rolled out, and prepared pie pastry (SuperDad took care of prepping the apples for filling) and then drove a couple miles to sit in a recliner, drink tea, and visit with a friend. By 5pm, my ankle was back to its normal amount of swelling — yes, just that little bit of activity is enough to cause my ankle to swell.  Welcome to my world!

 

 

 

 

 

Three Months Post-Surgery

Three months ago today, I had surgery for my trimalleolar fracture (compound breakage/shattering of just about everything possible in my ankle joint). I had already spent over 11 days in pain with my left foot/ankle elevated in the effort to reduce the swelling so that the surgical team could go ahead an operate.  When we met with the surgeon prior to surgery, he made sure we understood how serious the situation was: worst case scenario, I’d never walk again or severely crippled by arthritis in the ankle. I’m no athlete but I do enjoying hiking and camping, and just being able to walk, so I was pretty motivated to heal well.

Surgery itself was a 5-hour ordeal for which I was sedated and blissfully “sleeping” (best sleep I’d had in weeks!) and all of us — the surgeon, my husband and I — were pleased that all the repairs had been completed in a single event. Swelling problems could have prevented him from working on both sides of my ankle in a single day, but the easier repair was done and sewn up with no trouble, so he went to work on the more difficult portion as well.  In the picture below, I’m sure you can tell which side was more complicated to repair!

K's left ankle x-ray, webshare

This X-ray was taken on 25 Nov. 2015 while I was still knocked out for surgery. The last one taken  (4 Feb. 2016) shows proper healing but I don’t have a copy of it.

When I was about a month post-surgery, I wanted to know what my recovery would look like and I couldn’t get answers from the doctor. While I understand that everyone is different, I wanted — needed — a timeline for healing. All I found was this blog post, from someone younger, who was at an ideal weight and fitness level prior to her trimalleolar fracture and whose injury resulted in less hardware. While her milestones have been very helpful, I did not have the exact same experiences, so my purpose in posting today is to share what it has been like for me thus far for anyone else with a trimalleolar fracture.

The injury

I slipped and fell on my clean, dry kitchen floor on Friday, November 13th. At first we went to the Urgent Care Clinic, in hopes that I’d just dislocated my left ankle. They took an X-ray, wrapped my ankle in gauze and ace bandage, and sent us to the ER. At the ER they shook their heads over the simple bandaging meant to merely stabilize my ankle on a bumpy car ride, took better X-rays, and — after 4 attempts — “reduced” my ankle back into place. That experience was equivalent to the worst labor pains I’d had over four childbirths, in part because I had just spent 3.5 hours without pain relief, and it was just beginning to kick in when they attempted reduction. Emergency surgery on a Friday night is neither wise nor desired when one has an impressive amount of swelling (definitely not made better by the repeated attempts at reduction) so I was sent home with a prescription for Percocet and instructions to call for an orthopaedic appointment on Monday.

Monday was spent riding the health care insurance merry-go-round (by my husband; I was on Percocet, thankyouverymuch) and finally getting an appointment for Wednesday morning… which didn’t happen because a windstorm of historical proportions whipped through our region on Tuesday night,knocking out power everywhere. (Our home was without power for 8 nights, but that’s another post.)

The other thing we did on Monday was borrow a wheelchair from a friend. This was how I was transported to appointments. For home use (hopping to the bathroom on one foot), I had an old walker from a yard sale. Thank God for that $3.50 impulse purchase!
We finally saw an orthopaedic surgeon on Thursday, nearly one week post-injury. He told us how serious of an injury I had and noted how badly swollen I still was, so surgery was scheduled for the following Wednesday, November 25th. In the meantime, I was to be on my back with my foot and ankle elevated higher than my heart and nose. An upturned laundry hamper with pillows for padding under my legs did the trick. I continued to take Percocet to take the edge off the constant pain.

Post-Surgery to Three Months

I spent one night in the hospital. In part, this was due to such an intensive surgery (5 hours, 2 major incisions – one of which was difficult to close) and we believe it was also decided to keep me there because of our situation at home: we had been without power for 8 nights and 8 days, and there were no promises of when it would be restored. As it happened, the lights came back on around seven o’clock that night, so when we made it home on Thanksgiving day, the house had warmed up to a cozy 68 degrees Fahrenheit.  I was on intravenous Dilauded (hydromorphone) while in the hospital and it definitely does suppress a person’s ability to keep breathing while asleep. Hooray for CPAPs!
I was sent home with 2mg Dilauded tablets for pain. Staying on top of the pain was crucial; going too long between dosages would send the pain spiraling out of control, but the side effects of the narcotics were unpleasant.

For the next three weeks, I returned weekly to the doctor’s office for wound checks and to be wrapped up in a fresh cast/splint combination. At 13 days post-surgery, he removed the stitches from the side of the ankle with the simpler repair. He had hoped that both sides would be ready for stitch removal, but I still had significant swelling which worried him. It was another week before the surgical site had completely closed and the remaining stitches could be removed.

Some of that swelling was probably related to the 15 hours I spent out of the prescribed stranded turtle position (my name for it) when my husband drove us 80 miles to be at a different hospital for the birth of our first grandchild. Knowing now all of what was at stake in regard to wounds not closing properly, I understand why my surgeon was upset that I had disobeyed orders; at the same time, if given a chance to do it over, I would do it again — and he acknowledged that I had warned him in advance that I fully intended to do what I did. Still… no one likes to be chastised and if it hadn’t been for such an important event, we wouldn’t have done it. Open wounds can become infected, and this wound went right to the bone. Infection was a real danger.

At 3 weeks post surgery, with the wound finally closed and stitches removed, I was placed in a CAM boot but was told to put no weight on my foot whatsoever. Believe me, I had no desire to do so!  With the closing of the wound and the blessing of the doctor, I could put my foot in a lower position, so I was able to “do” a few things: watch a movie in the living room recliner, attend my son’s band concert in a wheelchair, attend a Christmas party with my husband, and go to church. Those events wore me out physically but helped my mental and emotional state. At least I was no longer limited to visits to the bathroom and visits to the doctor!

I began physical therapy after my 6 week post-op visit. The doctor told me to start bearing weight in my CAM-booted foot as tolerated. He also told me I shouldn’t need the strong pain meds anymore. I’d already cut back quite a bit but now was time to go off them. He explained that it would take up to four days but that my body would begin making its own natural form of opioids once the pharmaceuticals cleared from my system. I’m not sure if that is true, but I wanted to move on. Five days later my system was clear and I was no longer taking pain meds (although I continue to take Tylenol and Ibuprofen for pain) and I began driving myself to PT when the roads were not icy.  There are nights that I have trouble sleeping because of pain and/or spasms, but I like the freedom of driving so most nights I suffer until I can fall asleep. For the occasional truly miserable nights, when a cup of chamomile tea, a hot pad for my calf and a frozen bag of peas for my ankle doesn’t relax me or ease the pain enough to allow me to sleep, I take half of one of my remaining Percocet pills from before surgery — but that is always a last resort.

I had hoped the doctor would write a prescription (for insurance purposes) for me to get one of those cool knee scooters. Initially I wasn’t able to use one because of my issues with swelling and the need to keep my left foot elevated. However, once I was allowed to put a little weight on that foot in the CAM  boot, he said he wanted me using that foot, not babying it,  so I was stuck with using a walker for the month of January. It is a slow mode of transportation. Physical therapy has been very important in teaching me how to walk without limping or injuring my back with overcompensation.

At the beginning of February, one month after my 6-week post-op visit, I saw the doctor for what might be the final time (unless I have future problems with the ankle or the hardware). Fresh X-rays showed that my ankle has healed well and he told me “ditch the old lady walker” and resume life as normal. Easy for him to say! I found the concept of putting weight on my unprotected foot to be terribly frightening. The physical therapist has a much more measured approach. I am walking at home and at PT in bare feet with the walker, learning to put normal amounts of weight on that foot. The rest of the time I wear the CAM boot on my left foot, a hiking boot on my right foot, and use a 4-point cane for stability as needed — particularly for uneven surfaces, curbs, and stairs. I’m still slow but not as slow as I was a month ago when I could barely put any weight on my foot at all. There are times now that I am barefoot in my house and I use the walker to get across the room, then forget to use it to return. This is progress!

I went back to work at the beginning of February. I only work two days per week and spend a good part of the time sitting, or this would have been impossible. However, I still swell up easily and a weekend of babysitting my grandson — with the 90 minute drive each way, the lack of time spent elevating and icing, and the carrying of extra weight — while I was thrilled to spend time with him, I’m still battling painful swelling 4 days after coming home. If it doesn’t go down soon, I’ll be plunging my foot/ankle/leg into contrast baths: a bucket of ice water as long as I can bear it, then a bucket of warm bath water, then a bucket of ice water… Does that sound like fun? It’s my last resort but I may soon be trying it.

I decided to tag/categorize this post as Thankful Thursday because I am aware that, despite the pain and frustration which accompany me on this journey to healing, I am doing so much better than I was led to believe I would be doing. When I first injured my ankle, I thought it would be about 6 weeks before I would be walking again. Denial, much?  And yet, when I first met with the surgeon, he warned me that I might never walk again or that I might have crippling arthritis. It’s true that I am regularly hovering at 3-to-4 on my personal pain scale (between 3-and-5 on the scale with bees) and that I often reach 6-to-7 during physical therapy or at the end of a busy day; however, there is an awful lot of hardware inside my ankle. My left ankle is a full inch larger in circumference than my right ankle at this point in time. I hope that is due mostly to swelling and that I don’t continue to rock that steroid look, but I would much rather have a fat ankle than not walk at all. I returned to work ten weeks after surgery and prior to that I was working from home on my laptop. I’m walking in a CAM boot away from home and walking barefoot with ready support at home. That’s a lot of progress! It’s important for me to continually remind myself that I’ve come a long way since injury.

If you’d like to read all of my post-injury blog posts in order, you can start with this one and move forward chronologically. I’ve also put all of my “journey to healing” posts under that category, so you could use that term to search for the posts that way. (There’s a search engine and category cloud on the sidebar to the right.)

Attitude? I have a few of those…

Procrastination sign

  1. For my 50th birthday, I got up early, had fresh x-rays taken of my ankle and then went to visit the surgeon. The news was good: everything lined up with surgical repairs has stayed lined up and is healing. He and SuperDad were nearly giddy with relief over it, being the medically-minded people they are and knowing all of the potential pitfalls and poor outcomes we avoided. I was too emotionally spent to react with anything other than tears (which I avoided… barely) as I was clawing my way out of 24 hours of quicksand-like depression. Some people are hounded by the Black Dog; I flounder in quicksand. The doctor wondered why I wasn’t smiling, but since he had proven to be a rather single-minded orthopaedic surgeon, I didn’t bother explaining.  Talking would have brought on the tears, and I didn’t need a lecture about why I should be happy.

    A&K, 50 in 3x4 pic

    The day did indeed improve. Some very good friends brought a dinner party to my house that evening, complete with entertainment and tiramisu. I was beyond blessed.

  2. With my surgeon’s approval, I’ve been putting weight on my securely booted foot for a week now. Of course, I do this using my walker, and it’s probably only about 15% of the normal amount of weight one would use, but this is progress. It’s been nine weeks since I broke my ankle and 7 weeks since I had surgery. I honestly didn’t expect to be at this point already. The doctor had been purposefully vague about a timeline during the immediate post-surgery recovery period, and even prior to surgery. All I really knew was that his other patient with such a bad/complicated break had gone back to work after 4 months of recovery. (That patient had a job requiring standing.)
  3. I don’t feel like I have 4 months to wait. It’s already been 2 months and I’ve been working from home as much as possible. For the first month, I didn’t even have a replacement at work; now I do, but it is the busiest time of the year with annual reports (one is financial which goes to individuals, per IRS regulations; one is comprehensive and built from multiple sources of input.. now if only those multiple sources will all turn in their individual reports in a timely manner) and this is on top of the regular monthly reports which are due at the same time. My sub is awesome; she’s organized and loves the work. (I see vacations in my future!) I’ve gone into work for a few hours the past 2 days, but having my foot down for more than an hour or two causes painful swelling. So I don’t really know when I can fully return to my part-time job. 
  4. I’m currently on a twice-a-week schedule for physical therapy. After Monday’s session and a short shopping trip, we pulled into the garage and I shuffled to the back of the house to remove my CAM boot and elevate my foot for a few hours. This was my first real PT session, and it only took a couple of hours before the pain hit. Luckily, Wednesday’s session was not as bad, or perhaps it is because I kept up on the ibuprofen and acetaminophen dosages.  I’ve been off “the good stuff” (or bad stuff, as I think of Dilaudid) for a week now. For several nights before and several nights afterward, sleep was elusive and getting comfortable was equally difficult; if my foot wasn’t spasming to try to relieve pain, the weight of the blankets was too much to bear. SuperDad solved this  by building a blanket cradle. He misses the weight of the blankets on his feet, but my ankle in its soft boot for sleeping (a.k.a., a Dorsiwedge™ boot without the wedge because I still can’t really get to a neutral position) is very happy to not have the extra weight.
  5. After Monday’s PT session, I accompanied SuperDad to Costco; he pushed the cart while I wheeled myself through the store in a wheelchair. He only picked up about a dozen items, one of which was a packet of photos that I could reach but not see if it was mine from my seated position. I’m seeing life through very different eyes these days. The world is not, for the most part, wheelchair friendly:  poorly maintained sidewalks and ramps, handicapped-accessible parking areas not de-iced or salted on freezing days,  heavy doors that close quickly –these are all things that I’m noticing in my slower-paced world. I had hoped to get one of those knee scooters, but the doctor has told me to get up and walking with my walker. On the plus side, as long as I can safely get myself in and out of the vehicle without help (this includes folding and unfolding the walker from the back seat), I have a little freedom: I’m now allowed to drive!  Whoohoo! 
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TBT:  Here is The Engineer as a 14-month-old, playing at “driving” our parked minivan. I don’t display that kind of joy behind the wheel.