So I've finished a week of physical therapy, and a week back at work. Physical therapy has been okay so far. Since I can't put any weight on my ankle, it's mostly been stretching and core exercises (working glutes, quads, hip flexors, abs, etc.) so that I'll have the strength to walk once I reach that point.
I, of course, have home exercises to do, and I've been doing about twice as many as suggested. Any lack of recovery won't be from lack of trying on my part!
The only item of concern so far is that my Achilles has been extremely swollen (two to three times as wide as normal). My physio was able to get some of the swelling down with ultrasound and massage, and that allowed us to see and feel a knot right at the junction of my calf muscles and my Achilles. Looks like I must have injured it at some point. I just hope it isn't injured too badly!
Sunday, September 20, 2009
Monday, September 14, 2009
Day 51: Hi Ho, Hi Ho, It's off to work I go...
Off to work tomorrow. I'll be working 5 hours shifts for the next couple weeks. And obviously I'll have to keep my right foot elevated all day every day. But finally back to work!
Wednesday, September 9, 2009
Day 46 - One Cast Down, or Out of the Cast and Into the Boot
So I had an appointment with my doc yesterday, and my left ankle is now out of a cast! Instead, it's all immobilized in this big black boot/splint. It's still not supposed to be weight bearing, but least now I can wash my leg and stretch my ankle. I will hopefully start physical therapy this week.
My right ankle is in a new RED cast (Go State!) and will be for another two weeks.
I didn't have new x-rays taken, but my doc pushed and poked and prodded my ankles pretty thoroughly and we didn't find any pain. This apparently indicates that the bones are healing well.
I expect my left ankle will remain in the boot for two to four weeks, and then move to a splint. My right ankle will remain in its cast for another two weeks and then be put into a boot where it will remain for two to four weeks.
Blood flow out of my right ankle remains an issue. Every time I hobble around on my walker, I look down to see purple toes. But it's improving, and I hope to be returning to work before too long.
The new boot is this heavy plastic footbed, with aluminum stays up the side, and a big neoprene wrap and six straps to keep my foot and ankle in place. I was trying to describe it to somebody and said: "it's sorta like Darth Vader meets neoprene." Now I'm jokingly referring to it as my "Darth boot". (You'll notice that I put in an orange Superfeet footbed, which looks a little silly but makes the boot much more comfortable.)
My right ankle is in a new RED cast (Go State!) and will be for another two weeks.
I didn't have new x-rays taken, but my doc pushed and poked and prodded my ankles pretty thoroughly and we didn't find any pain. This apparently indicates that the bones are healing well.
I expect my left ankle will remain in the boot for two to four weeks, and then move to a splint. My right ankle will remain in its cast for another two weeks and then be put into a boot where it will remain for two to four weeks.
Blood flow out of my right ankle remains an issue. Every time I hobble around on my walker, I look down to see purple toes. But it's improving, and I hope to be returning to work before too long.
The new boot is this heavy plastic footbed, with aluminum stays up the side, and a big neoprene wrap and six straps to keep my foot and ankle in place. I was trying to describe it to somebody and said: "it's sorta like Darth Vader meets neoprene." Now I'm jokingly referring to it as my "Darth boot". (You'll notice that I put in an orange Superfeet footbed, which looks a little silly but makes the boot much more comfortable.)
Saturday, August 29, 2009
Day 35 - Same ol', same ol'
Nothing new to report. Still concentrating on keeping my foot up. Blood flow out of my ankle is improving, but only little by little. Still a long way to go.
My dad left on Thursday. He's returned home to take care of things there for a couple weeks, and will be coming back out later in September. My mom, ever the trooper, is still here. Don't know what I would do without them!
My dad left on Thursday. He's returned home to take care of things there for a couple weeks, and will be coming back out later in September. My mom, ever the trooper, is still here. Don't know what I would do without them!
Sunday, August 23, 2009
X-rays after second surgery
Finally able to upload the x-rays after my second surgery. I think the only new hardware is the long screw that is connecting by tibia and fibula. With some luck, this will be removed in about 12 weeks, once my ankle stabilizes.
Friday, August 21, 2009
Day 27 - Orthopedics Appt.
Back to the doc today. Everything looking good, so the final sutures were removed from the outside of my right ankle and replaced by steri-strips. My right ankle was put in a cast rather than back into a splint, and it will probably be there for a month.
Swelling is so far down it actually looks like my foot again! As always, surprising how far my leg has atrophied.
This was right after the sutures were removed, and before the incision was steri-stripped. Looks SO much better than it did 3 weeks ago!
So now I've got two casts - my left is in sort of a burgundy/cabernet/merlot color and the right is in blaze freakin' fluorescent orange. (Really, the orange is crazy bright. The photo doesn't begin to do it justice.)
Swelling is so far down it actually looks like my foot again! As always, surprising how far my leg has atrophied.
This was right after the sutures were removed, and before the incision was steri-stripped. Looks SO much better than it did 3 weeks ago!
So now I've got two casts - my left is in sort of a burgundy/cabernet/merlot color and the right is in blaze freakin' fluorescent orange. (Really, the orange is crazy bright. The photo doesn't begin to do it justice.)
Tuesday, August 18, 2009
Why So Elevated?
When I did all this damage to my right I ankle, I managed, thankfully, not to do any serious damage to the major veins and arteries in my ankle. No blood spurting from the wound or anything like that. Instead my tibia just shredded a tendon on its way out of my leg.
While I didn't damage the big vessels, I did wreak absolute havoc on all the small veins and lymph vessels all around my ankle. This means that blood gets down to my ankle okay, but doesn't get pumped back up very efficiently. Apparently this will take care of itself over the next six months or so, and will be much improved once I'm able to start flexing the ankle and working the muscles.
In the meantime, however, whenever my right foot is down, it fills with blood. If I leave it down for long (more than a couple minutes), it ends up turning a pretty dark shade of red and swelling noticeably and painfully. Only solution for now is to keep it elevated at or above the level of my heart. This is fine when I'm at home, thanks to a super comfy travel recliner I borrowed from some friends (it had proven its worth helping them recover from surgeries and injuries). But it is pretty darn difficult anywhere else.
While I didn't damage the big vessels, I did wreak absolute havoc on all the small veins and lymph vessels all around my ankle. This means that blood gets down to my ankle okay, but doesn't get pumped back up very efficiently. Apparently this will take care of itself over the next six months or so, and will be much improved once I'm able to start flexing the ankle and working the muscles.
In the meantime, however, whenever my right foot is down, it fills with blood. If I leave it down for long (more than a couple minutes), it ends up turning a pretty dark shade of red and swelling noticeably and painfully. Only solution for now is to keep it elevated at or above the level of my heart. This is fine when I'm at home, thanks to a super comfy travel recliner I borrowed from some friends (it had proven its worth helping them recover from surgeries and injuries). But it is pretty darn difficult anywhere else.
Monday, August 17, 2009
First Post-Op Appointment after Second Surgery
Went in today for my first post-op appointment after the second surgery (which was 6 days ago, last Tuesday). Things continue to progress well, although the x-rays showed that there are still some tiny, tiny bone fragments scattered through the tissue under my fibula.
What had the most impact on me, however, was how my surgeon described my injury. He has used the words "devastating injury" when describing it all to my parents, but he's never been quite that emphatic when talking with me. Today, when I was asking questions about the blood flow out of my ankle, he got right to the point.
He said something to the effect of: look, you came close to ripping your foot completely off. If you weren't young and healthy, you might have lost the foot, all the tissue there is extremely damaged....
gulp.
Oh.
I mean, I knew I had really done a number on my ankle. It can never be good to see bone sticking through your skin. And I knew I really sorta shattered the end of my fibula, which is why I've got the plate and all the screws.
But when your surgeon paints the picture that your foot was half off, that's something else entirely.
gulp.
Anyway, moving on, things seem to be progressing fine. As you can see below, swelling is way down, incisions seem to be healing well, so now we're just waiting for the bones to heal.
My foot is finally recognizable as my long and bony foot. No longer a balloon stuck on the end of my leg.
For the second surgery, the new incision was actually made right through the old incision. Looks so different without all the swelling!
The second surgery didn't include any work on the inside of my ankle. It's hard to tell from this photo, but the incision here from the first surgery is now practically smooth with the surface of my skin. I was afraid I was going to have a thick ropy scar, but that doesn't look to be the case.
The second surgery did confirm that the large chunk of bone visible in the CT scan, near the end of my fibula, was in fact the chunk that was missing from the end of my tibia.
Look at your own ankle and imagine this: a piece of bone, about 2/3 the size of a dice cube, was broken off from the back of your inside ankle bone (the rear of the tibia) and driven around and across the front of the ankle until it came to rest adjacent to the front of your outside ankle bone (the front of the fibula). Crazy huh?
But the piece was pretty badly mangled, and the cartilage left on it was badly damaged, so my surgeon elected to discard it rather than try to put it back in place because of all the risks that would incur.
Look Ma, two ankles! This is the first time I've seen both ankles in two and half weeks. With both legs down, so that you had something to compare it to, it was amazing to watch my right foot and ankle swell and change color as the blood drained into it and didn't get pumped back out. You can see this in the photo above, but it doesn't quite do it justice. It was also amazing to be able to watch my foot and ankle literally drain, once I elevated the foot. More on this in another post soon.
My poor calve muscles are so atrophied. (And I'm told I haven't seen anything yet. Ugh.) But at least the gashes on my shin are healing up well.
What had the most impact on me, however, was how my surgeon described my injury. He has used the words "devastating injury" when describing it all to my parents, but he's never been quite that emphatic when talking with me. Today, when I was asking questions about the blood flow out of my ankle, he got right to the point.
He said something to the effect of: look, you came close to ripping your foot completely off. If you weren't young and healthy, you might have lost the foot, all the tissue there is extremely damaged....
gulp.
Oh.
I mean, I knew I had really done a number on my ankle. It can never be good to see bone sticking through your skin. And I knew I really sorta shattered the end of my fibula, which is why I've got the plate and all the screws.
But when your surgeon paints the picture that your foot was half off, that's something else entirely.
gulp.
Anyway, moving on, things seem to be progressing fine. As you can see below, swelling is way down, incisions seem to be healing well, so now we're just waiting for the bones to heal.
My foot is finally recognizable as my long and bony foot. No longer a balloon stuck on the end of my leg.
For the second surgery, the new incision was actually made right through the old incision. Looks so different without all the swelling!
The second surgery didn't include any work on the inside of my ankle. It's hard to tell from this photo, but the incision here from the first surgery is now practically smooth with the surface of my skin. I was afraid I was going to have a thick ropy scar, but that doesn't look to be the case.
The second surgery did confirm that the large chunk of bone visible in the CT scan, near the end of my fibula, was in fact the chunk that was missing from the end of my tibia.
Look at your own ankle and imagine this: a piece of bone, about 2/3 the size of a dice cube, was broken off from the back of your inside ankle bone (the rear of the tibia) and driven around and across the front of the ankle until it came to rest adjacent to the front of your outside ankle bone (the front of the fibula). Crazy huh?
But the piece was pretty badly mangled, and the cartilage left on it was badly damaged, so my surgeon elected to discard it rather than try to put it back in place because of all the risks that would incur.
Look Ma, two ankles! This is the first time I've seen both ankles in two and half weeks. With both legs down, so that you had something to compare it to, it was amazing to watch my right foot and ankle swell and change color as the blood drained into it and didn't get pumped back out. You can see this in the photo above, but it doesn't quite do it justice. It was also amazing to be able to watch my foot and ankle literally drain, once I elevated the foot. More on this in another post soon.
My poor calve muscles are so atrophied. (And I'm told I haven't seen anything yet. Ugh.) But at least the gashes on my shin are healing up well.
So that's all for now. I'm back to laying back with my feet above the level of my heart. I've heard that PT is hell, but right now I can't wait. All this laying around helpless is killing me!
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