My ChronAnkle – Prologue

My ChronAnkle – Prologue

It is February 12, 2013 as I start this blog, so anything prior will be written in past tense. Once I am able to weight bear and progress physically, updates will be in the present tense. My goal is to focus on the physical progress and not wallow in the emotions and frustrations during these long, long weeks of non-weight bearing.

The blog will chronicle my progress from Achilles rupture through

Weight bearing
Walking
Walk my first mile
Return to dance

Tap
Musical Theater
Ballet
Pointe (we’ll see…)

Completing a 5K
And finally a Half Marathon.

Injury, Surgery and Post-Op

On January 3, 2013 I reputed my Achilles tendon in a freak accident at dance (musical theater).

I was in a bent knee lunge: right foot in front, both knees bent, both heels on the ground. Someone accidentally stepped on my left “rear” ankle, landing atop the Achilles about 5” above the heel and sliding down to the heel. There was instant pain and when I stepped forward, I went down, hitting the floor. I got up and finished the piece as just a few seconds remained. As soon as I got off stage (with help) the ankle was elevated and iced. I have not put weight on that foot since then.

Here are pre-op pictures:

Ankle pre-op 31

Ankle pre-op 31

Ankle pre-op 32

Ankle pre-op 32

Surgery  followed on January 8. It was a complete tear; the surgeon described it as, “trying to sew two mop heads together.” The surgeon was Dr. Carl Hollman in Cookeville, TN. We have seen him off and on for years and find him to be very conservative in treatment and frank in discussions. It helps that he also owns a working farm and understands the issues that our lifestyle and occupations present. He repaired my husband’s torn ACL  eleven years ago and we have complete faith in him.

I spent two nights in Cookeville Regional Medical Center, and was very pleased with the care and attention received.

I was in a plaster splint that wrapped ¾ of my leg, open from the shin down, and the entire thing was encased in 2 Ace bandages. In a week I returned and the splint was removed, the incision checked out, and a new splint installed.

open splint

open splint

Plaster & Ace bandage splint

Plaster & Ace bandage splint

I had issues with that splint not fitting right and had to go back the following day for a replacement. Then week later, back again for the stiches to come out and my first fiberglass cast.

Here are pics of the staples and the cast. Yes, I agree that the ankle looks gross.

Stitches (AKA "Zombie Leg")

Stitches (AKA “Zombie Leg”)

Blue Fiberglass Cast

Blue Fiberglass Cast

February 21 will be a new cast; in this one the ankle will be set at 90 degrees.

The Initial Prognosis and Game Plan

Dr. Hollman has said from the beginning that he “predicts a full recovery.”  Time lines have not been discussed aside from 12 weeks of ZERO weight bearing. Me, being me, I want to duct tape him to a chair and interrogate him as to each and every specific date and time I can expect to do what—but he seems to be more of a “one thing at a time” kind of guy.

I did ask last visit if I could use a physical therapist (PT) with whom I have a history and his response was a surprising, “We’ll get you walking and then see if you need PT. If you do, then yes you can go back to Larry Burkes, but we’ll see if you even need it.”

Now THAT is VERY different from everything I’ve read on the Internet which describes a solid month of PT before weight bearing commences and then months and months of PT after.

This site describes a typical rehab program:

http://www.sportsinjuryclinic.net/sport-injuries/ankle-achilles-shin-pain/total-rupture-achilles-tendon/rehabilitation-achilles-ruptures

So it is clear that Dr. Hollman has his own treatment plan, so we will go with that and see…..

More About Me

I am 47 years young <smile>, live and work on a farm www.peacefulpastures.com , and over the previous 2-3 years have led a very full and active life including Pilates, yoga, 2 Bible studies, horses and my beloved dance classes (tap, musical theater, ballet and pointe)  at Stage One in Cookeville. I love to cook and do so extensively as I cook a big lunch for all the farm’s employees. My other interests including reading and knitting. I am also a Disney junkie.

In November 2012, I completed my first ever half marathon. Here is my post from Facebook and a photo:

Disney Food and Wine Half Marathon 2012

Disney Food and Wine Half Marathon 2012

Crossing the finish line was very emotional–when I was born (6 weeks early) my lungs were not developed and my parents were told I would not survive. Then when I was 7, I caught a fungal lung disease for which there was no treatment at the time. Again, my parents were told I would not survive. The effects of the di sease are that 60% of my lung surface area is calcified–so I only have 40% lung capacity. And when I was 24, I developed asthma. So even the thought of a half marathon was “temporary insanity.” But I felt “God Encouraged” to do it. :-) As I crossed the line, I was saying aloud, “I can do ALL things through Christ who strengthens me.” Phil 4:13

The rupture was January 3rd : I was to be on stage for performances January 4 & 5, and doing a 5K with a girlfriend January 11 followed by another half marathon January 12. So needless to say, my world came crashing to an end.  Which is a good lead in to my next section….

The Emotional Implications

Most will say that I am not super emotional, especially as far as chicks go…  I am emphatically practical and rather driven. This injury and its implications were DEVASTATING. As I had the MRI the tears trickled out as I tried to hold it together.

What would I be able to do again? When? I had returned to ballet pointe classes after 28 years—would I ever do it again? What about running? And riding, how would I use that foot in the stirrup—and when???

And I am a Born Again Christian. During my emotional  despair, some thought (incorrectly) that I was asking, “God, Why me?” but that is not the case. Instead, it was, “God, Why NOW?”

I seemed to be exactly where I needed to be and loving where I was. I so enjoyed interacting with all the young ‘uns in musical theater (ages 13-25), In Community Bible Study we were doing one of my Bucket List items (a year long study of the book of John), in Precepts Bible Study after years of not being able to find a group, I’d found a new home for my heart with a group in Lebanon and I was continuing to marvel at God’s blessing of my physical health and stamina.

And here I was/am—on the couch. Grounded. For weeks and weeks upon end.

My lowest point was shortly after I returned home; one night I could not sleep (narcotics are a stimulant for me) and I found a web site of Achilles rupture/repair blogs and Oh. My. God. It was HORRIBLE. Story after story of

“It’s been 9 months and I still walk with a limp”

“6 months out of the cast and I can’t go up or down stairs”

“One year later and I am just now allowed to jog”

I was crying and dry heaving into the trash can simultaneously. SO MANY people and NO happy endings.

I was teary and upset for days. I stopped wondering about dance and anguished over whether I would even WALK normally again. It was my lowest point.

Three texts from dear people held me clinging to the edge of Despair’s Pit instead of falling in.

“Don’t forget the God whom you serve and the great plans HE has for your healing.”

“The people who HAVE healed are outside doing stuff—not inside writing depressing blogs.”

And

“The people that write those negative blogs are only doing so because they got tired of watching disability lawyer’s ads on TV.”

Pain Management

I am often asked whether I hurt now and what the pain was prior to surgery.

At the time of the injury, there was sharp pain, akin to whacking your shin. As I previously described, the ankle was IMMEDIATELY iced and I took 800 mg of ibuprophen. From then until surgery as long as the ankle was not jostled too much, I had NO pain. None. I understand that this is very atypical, and I can’t help but feel it was God’s intervention.

My first night in the hospital was rough, but not awful. The pain stayed at 3-4 on a scale of 1-10, but was able to rest. At times it would reach a ‘7’, and I found the nurses to be prompt and concerned about pain management. As I have already said, narcotics act as a stimulant to me, so the lack of sleep was a side effect of the pain meds (Percocet and Dilaudid), not the pain itself. I stayed the second day and night to allow the Rx program to get ahead of the pain. The Dr. suggested I stay and I was more than happy to do so. At my insistence they switched from Dilaudid to Demoral as that drug will knock me out. I was able to sleep for 2-3 hours at a stretch—until I began to react to the meds.

My body had “just about had enough!” of pharmaceuticals and hit the “eject” button at the expense of the grilled cheese sandwich I had consumed. Afterwards I felt oh so much better. I got some Reglan for nausea, they dropped the Demoral  after throwing in a mini scold of “This is why we don’t like Demoral…” But I felt much brighter and like I had turned the corner.

At home, I took meds (Percocet and Tylenol 3) only as needed and only had to have them round the clock for the first few days, and even then I was not taking the full dose.

Since the fiberglass cast, my pain has been limited to occasional bouts of cast Vs. incision. FYI-the cast always wins.

And now (2-18-2013)

It is still hard. I won’t lie. The biggest challenge is boredom and restlessness. For years, others have described me as “high energy.” I never believed them until now. You don’t realize how much energy and need to move you have—until you can’t. A surprise has been that I do not enjoy reading. I am too restless and unfocused; I constantly fidget and wiggle. And my mind both wanders and races. Audiobooks help keep my mind occupied while knitting or typing keep my hands busy. I also text friends frequently.

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