Since other folks recovering from ankle and leg injuries occasionally end up on this blog, I thought I would post a few thoughts on healing and recovery.
Get help
First off, get help. Friends, family, a rehab center. Whatever you have to do. Get somebody to give you a hand, and accept the help. I definitely credit my quick healing in the past (and hopefully this go-round as well) to the amazing help I've gotten from my family.
When you're this banged up, driving is obviously out, so you'll need somebody to cart you around. But help for all the other daily tasks (that we normally take for granted) is just as important. If you have to stand up to do dishes, cook food, do laundry, etc., your foot is down and probably swelling quite badly. Not good for healing. Accept the help.
Really elevate
Really (really!) elevate your foot. Not just propped on a chair. Keep it at or above your heart. This probably means a recliner and lots of pillows. One of my docs early on emphasized the importance of keeping it so elevated, and I've found it makes a huge difference. One of those camping recliner/lounger chairs works well if you don't have a typical recliner (and is much cooler in hot weather). Something like this (shameless plug for REI) is a good place to start: http://www.rei.com/product/812204/rei-comfort-lounger-chair
Stay active
Stay active. Do push ups or sit ups or whatever. Get outside if you can. Roll around the neighborhood or local park in your wheelchair or knee scooter. Get out and stay active. Once you're in PT, do everything your PT tells you to, and then do it again (and maybe a third time for good measure).
Knee scooters!
If it's an option for you, use a knee scooter rather than crutches. Crutches are useful for tight spots and stairs, and not bad for around the house, but otherwise knee scooters are (without question) the way to go. Just make sure you get one you can steer. I spent hours on the phone with my insurance company getting a knee scooter sorted out this time around, and it was definitely worthwhile. More here: http://twobrokenankles.blogspot.com/2009/10/knee-scooter.html
Shower covers
Get one of the cast covers for the shower. They're not terribly expensive, and they are much (much!) better than any home made alternative (usually trash bags and duct tape). The one I have is much like the original one shown here: http://www.medcareproducts.com/castcovers/ Oh, and you'll need some sort of plastic stool for sitting in the shower as well. Again, a small and worthwhile investment.
That's all I've got for now. Let me know if you have any questions!
Wednesday, March 7, 2012
Not much new to report
Not much new to report right now. I've returned to work, and amuse my colleagues by zipping about the office on my knee scooter. Best I can tell, everything is healing well and quickly. Still no pain. Still swelling if I don't keep my foot up (though that has improved slightly). I go back in next week to have my cast taken off and another x-ray taken. Hopefully the doc will tell me good things at that point.
Thanks for checking in!
Thanks for checking in!
Tuesday, February 21, 2012
Images from Post-Op
So, after a crazy last week, I'm finally posting images from my post-op appointment.
The first are three x-rays, showing the two huge screws holding everything together. If I remember the doc correctly, they are 6.5 mm in diameter. The other smaller screws and anchors are left over from earlier surgeries.
I think I mentioned in an earlier post that the surgery ended up only being a single incision on my ankle, and another very small incision at my knee. They are healing nicely, as you can see here:
And finally, for everyone that wanted to see what I look like with a full beard, here's a pic. My parents didn't even recognize me at the airport!
The first are three x-rays, showing the two huge screws holding everything together. If I remember the doc correctly, they are 6.5 mm in diameter. The other smaller screws and anchors are left over from earlier surgeries.
I think I mentioned in an earlier post that the surgery ended up only being a single incision on my ankle, and another very small incision at my knee. They are healing nicely, as you can see here:
And finally, for everyone that wanted to see what I look like with a full beard, here's a pic. My parents didn't even recognize me at the airport!
Friday, February 17, 2012
Chest pain?
So things have been interesting this week. Monday, not too long after I finished the previous post, I ended up in the ER with chest pain and difficulty breathing. After a CT scan, the doc in the ER determined that it wasn't a pulmonary embolism (which is the big worry after a surgery like mine) and sent me home.
Long story short, I still felt horrible. Like a 90 year old man with a bad heart. Chest pains and trouble breathing make you feel like you're dying. I don't recommend it.
After several more doctor visits and a few tests, it's finally been determined that I have pericarditis, a condition in which the sac-like covering around the heart (pericardium) becomes inflamed. Breathing deeply hurts because the expanding lungs push on the pericardium. Laying down or bending over hurts because things shift behind the chest wall and push on the pericardium. Heart rate is high because the heart isn't able to expand as fully as it otherwise might. Not fun.
Interestingly, this is apparently unrelated to the ankle surgery in any way, and is instead probably the result of a bug I caught some time in mid January.
The good news is that I have only a minor case and it isn't life threatening. The bad news is that it can take 12 weeks to clear up. I have already seen some improvement (my doc says I'll have good days and bad days) but at least I no longer feel like I'm dying.
That actually becomes an interesting perspective. I may not feel 100%, but when compared to feeling like I'm dying, I feel great.
Long story short, I still felt horrible. Like a 90 year old man with a bad heart. Chest pains and trouble breathing make you feel like you're dying. I don't recommend it.
After several more doctor visits and a few tests, it's finally been determined that I have pericarditis, a condition in which the sac-like covering around the heart (pericardium) becomes inflamed. Breathing deeply hurts because the expanding lungs push on the pericardium. Laying down or bending over hurts because things shift behind the chest wall and push on the pericardium. Heart rate is high because the heart isn't able to expand as fully as it otherwise might. Not fun.
Interestingly, this is apparently unrelated to the ankle surgery in any way, and is instead probably the result of a bug I caught some time in mid January.
The good news is that I have only a minor case and it isn't life threatening. The bad news is that it can take 12 weeks to clear up. I have already seen some improvement (my doc says I'll have good days and bad days) but at least I no longer feel like I'm dying.
That actually becomes an interesting perspective. I may not feel 100%, but when compared to feeling like I'm dying, I feel great.
Monday, February 13, 2012
First Post-Fusion Appointment
I had my first post-op appointment today, after the ankle fusion. Doc and PA were definitely surprised to hear how quickly I was off pain meds. Incisions are healing nicely, and swelling, though visible, was fairly minimal. The only incision in my ankle was along the outside, but not up the main incision, instead it was along the line of one of the minor incisions from the last surgery. When this is all said and done, I'll have two pretty significant scars running up the outside of my ankle. I did get a new cast, in the same burgundy color I've had before.
Mom took some pics, and I'll get them posted before long.
I did learn a little more about the recovery plans. I'll be in the cast for four weeks, no weight bearing. Assuming that the fusion is going well and the bones are growing together, I'll move from the cast to a rigid boot at the end of four weeks (six weeks after surgery) and will probably be allowed partial weight bearing for the next four weeks (10 weeks after surgery). At that point, I'll probably be allowed to put my full weight on the ankle, but will still be confined to the boot. At some point after that, I'll switch to normal shoes. Full bone fusion will probably take about four months total, if I remember right.
Things continue to go well, and I have very little pain. The biggest issue is just keeping my foot elevated to minimize swelling.
Mom took some pics, and I'll get them posted before long.
I did learn a little more about the recovery plans. I'll be in the cast for four weeks, no weight bearing. Assuming that the fusion is going well and the bones are growing together, I'll move from the cast to a rigid boot at the end of four weeks (six weeks after surgery) and will probably be allowed partial weight bearing for the next four weeks (10 weeks after surgery). At that point, I'll probably be allowed to put my full weight on the ankle, but will still be confined to the boot. At some point after that, I'll switch to normal shoes. Full bone fusion will probably take about four months total, if I remember right.
Things continue to go well, and I have very little pain. The biggest issue is just keeping my foot elevated to minimize swelling.
Wednesday, February 8, 2012
A quick note about the original fall
Just a quick note to clarify the accident that started all this. Most everyone that learns that I broke my ankles in a climbing accident assumes that I fell to the ground (or "decked out") and broke my ankles on impact. While many climbing injuries certainly do happen that way, that wasn't the case here.
Instead, I slid down an angled slab of rock. I probably slid 20 or 30 feet before the rope brought me to a stop. At that point, I was still 20 or 30 feet off the ground. As I slid, my feet caught (either in a crack, or on a bump, I don't know which). My momentum kept me sliding, even though my feet were stopped, and that's what did such terrible damage to my right ankle.
Nothing much new to report today. Pain level is still pretty low, but I still have to keep my foot quite elevated.
Instead, I slid down an angled slab of rock. I probably slid 20 or 30 feet before the rope brought me to a stop. At that point, I was still 20 or 30 feet off the ground. As I slid, my feet caught (either in a crack, or on a bump, I don't know which). My momentum kept me sliding, even though my feet were stopped, and that's what did such terrible damage to my right ankle.
Nothing much new to report today. Pain level is still pretty low, but I still have to keep my foot quite elevated.
Tuesday, February 7, 2012
All good after surgery
Surgery to fuse the ankle took place last Wedensday, Feb 1. All apparently went quite well. The surgery took considerably less time than anticipated, partly because I had no cartilage left that the doc needed to clean out.
My surgeon reported that the bone surfaces at the joint were badly deteriorated, but that the surrounding bone was healthy, strong and hard.
What he did in a nutshell was: carve out a place at the bottom of my tibia, shave down my talus (the small bone that sits beneath the tib and fib) and fit the two of them together. Then he pulled bone marrow from the top of my tibia (near my knee) and used it like grout to pack the joint (this apparently speeds the growing/fusing process). Finally, he bolted the tib and talus together with giant (6.5mm, I think) screws.
I ended up in the hospital overnight, but for less than 24 hours. Once again, the staff at Overlake hospital up in Bellevue were quite good.
Pain has been very minimal, and I haven't needed heavy duty painkillers since Saturday morning. I do have to keep my ankle elevated above my heart or it gets swollen (and the pain ratchets up) very quickly. This means lots and lots (and lots) of time sitting in a recliner or bed with my feet propped up high on pillows. Comfortable for a short time, not so much for days on end. Today is the first time I've been able to manage without quite so many pillows. A small, but nice, change.
Things could definitely be worse.
My folks have, again, been heroes, and are out here for the long haul. They're planning to stay until I can drive again (6 - 10 weeks) which is fantastic. I definitely credit my speedy healing in the past to the care they provide. If I had to spend more time on my feet cooking, doing dishes, washing clothes, etc., my foot would be much more swollen, I would be in a great deal more pain, and I don't think the healing would happen nearly as quickly.
I'm still a little confused about the recovery time line, but definitely no weight bearing for 6 to 10 weeks. And then several months before totally healed. I go back next Monday for a follow-up appointment to take out stitches, check healing, take x-rays, etc., and I should know more then.
For now, I'm going to hobble out to the porch on my crutches and sit in the sun and enjoy this marvelous fall day (never mind the fact that it's February).
My surgeon reported that the bone surfaces at the joint were badly deteriorated, but that the surrounding bone was healthy, strong and hard.
What he did in a nutshell was: carve out a place at the bottom of my tibia, shave down my talus (the small bone that sits beneath the tib and fib) and fit the two of them together. Then he pulled bone marrow from the top of my tibia (near my knee) and used it like grout to pack the joint (this apparently speeds the growing/fusing process). Finally, he bolted the tib and talus together with giant (6.5mm, I think) screws.
I ended up in the hospital overnight, but for less than 24 hours. Once again, the staff at Overlake hospital up in Bellevue were quite good.
Pain has been very minimal, and I haven't needed heavy duty painkillers since Saturday morning. I do have to keep my ankle elevated above my heart or it gets swollen (and the pain ratchets up) very quickly. This means lots and lots (and lots) of time sitting in a recliner or bed with my feet propped up high on pillows. Comfortable for a short time, not so much for days on end. Today is the first time I've been able to manage without quite so many pillows. A small, but nice, change.
Things could definitely be worse.
My folks have, again, been heroes, and are out here for the long haul. They're planning to stay until I can drive again (6 - 10 weeks) which is fantastic. I definitely credit my speedy healing in the past to the care they provide. If I had to spend more time on my feet cooking, doing dishes, washing clothes, etc., my foot would be much more swollen, I would be in a great deal more pain, and I don't think the healing would happen nearly as quickly.
I'm still a little confused about the recovery time line, but definitely no weight bearing for 6 to 10 weeks. And then several months before totally healed. I go back next Monday for a follow-up appointment to take out stitches, check healing, take x-rays, etc., and I should know more then.
For now, I'm going to hobble out to the porch on my crutches and sit in the sun and enjoy this marvelous fall day (never mind the fact that it's February).
Monday, January 16, 2012
Getting ready for surgery
Getting ready for more surgery, to fuse the main ankle joint (tib to talus). X-rays this morning show that I am truly bone on bone. Nice, huh? This x-ray illustrated it best:
Compare this with an earlier x-ray, below, and it becomes very clear how much my ankle has deteriorated. (It's not quite the same x-ray view, but it illustrates the difference.)
Compare this with an earlier x-ray, below, and it becomes very clear how much my ankle has deteriorated. (It's not quite the same x-ray view, but it illustrates the difference.)
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