Reflections on the first 4 Months

I’m 4 months in, today, from my calcaneal exostectomy to remove a Haglund’s Deformity, and Achilles’ tendon repair. My surgeon said recovery would be long and hard, and progress very gradual. He was right about that. I have made progress, but I’m still in pain, every day, with every step.
After 4 months, my having had surgery is a distant memory to those around me, yet such a large part of every aspect of my daily life. Ongoing PT, daily exercises, stretching, elevating, icing, resting…..maybe some cursing!! And an ever growing list of things I want to do, wish I could do, used to be able to do, really hope to be able to do again one day. I hold onto that hope. I believe in that hope.
Although not as often, people still ask, “How’s your ankle?” As time goes on, the answer gets harder and harder to continue repeating. What they want to hear is, “It’s great”, or “it’s all back to normal”. That’s what I want the answer to be. But instead, it’s “It’s coming along” or, It’s up and down”, or, more often than not, ” It’s miserable today”. And the disappointment on their face is ever more crushing. So it becomes easier to just stop talking to people. To just do your own thing, go about your day by yourself, stay close to the ones who understand it’s a long process, and it’s not going to be all better tomorrow, or the next day, and probably not even the day after that! At one point my Grandmother actually thought I was mad at her because I hadn’t called. She wants that “It’s all better” answer more than anyone. Sometimes I think even more than me!! I’ve explained to her time and time again, that it’s a long road. But it’s in her nature to want it better RIGHT NOW!! I guess that’s where I get it from!
The other question that gets asked is, “Do you regret having surgery? Would you go back and do it again?” Regret? No. I know it was the right decision at the time. Would I go back and do it again - ie. make the same decision? Yes. Would I have the same thing done on my other ankle should need arise? The best, honest, deep down in my soul answer I can give to that question is, I don’t know. If it meant being in a cast again, even for a few days, then, no. Unless they also put me into a coma!!
I look at other blogs and see people progressing differently than me, but I know my story is unique. I’m 4 months post op. 15 months post op from my os trigonum excision and FHL tendon repair. 25 months past that fateful day where all I did was step off a sidewalk, and, little did I know at the time, my whole world changed. If I could go back, maybe I would just stay home that day. Would that have made all the difference? We’ll never know. I doubt it.
So, I keep plugging along. At my own pace. It’s the only pace I know how to do. Are there others progressing faster? Yes. Are there others dealing with a great deal more of a struggle? Yes. Is there anyone else in the world who shares my same incredibly rare combination of ankle issues? Probably not. If there are, I’d love to hear from them. Anyone? Anyone? Bueller?!!
In the meantime, for now, I hold onto the hope that I may walk pain free one day. Today is not that day. That’s OK.

Trying some new things with PT

I had a really good, albeit slightly torturous (!) PT session today. My ankle and whole lower leg has been getting stiffer and tighter lately, despite my best efforts to keep it stretched out and moving. I’ve been losing range on inversion, and still have very little on dorsiflexion. So my PT did a lot of manual work to mobilize my ankle today. It didn’t feel great while she was doing it, but at the same time felt good because I felt like I was actually receiving treatment. Afterward it felt a little looser. Then she did some deep tissue massage on my soleus….holy geez….PAINFUL!! But everything in there is so tight. I’m going twice next week for more. Hopefully this will help things move along a little. My “comfortable” walking distance is still ridiculously short (100 yds…maybe, probably not even that far), so hopefully this will help that as well.

Maybe next week I’ll be braver…

I had my 11 week follow-up with my surgeon yesterday. I managed to “complete my homework” from my last visit, in that I walked into his office, on my own two feet, in matching shoes! And it was like he knew how I was feeling before I even said hello. So either, he’s some sort of psychic mindreader, or most people who go through this surgery feel about how I do at this point. I suspect it’s the latter! Or maybe I was just exuding frustration and discouragement when I got there. We had a nice chat.
He really made me realize that having part of your heel bone sawed off is a major thing. I have such a neat little line on the outside of my ankle it’s easy to forget the real trauma of surgery. He stressed that if this was an easy procedure, he’d be doing a lot more of them. Anyway, he said with what he did, and my history, I’m about where he would expect me to be at this point. And that progress is, and will continue to be, very slow and very gradual. He encouraged me to keep track of how I’m feeling and what exercises I’m doing so I can go back and see that I am, in fact, making progress. I already do this to some extent, but I’m going to start keeping more detailed notes. And he said he expects it will take me at least a year before I start feeling somewhat normal. Sigh. But in reality, I knew this going in.

I expressed my concern with how fast, and with such a little amount of standing or walking, I go from reasonably good to really bad, but he said not to worry, it will get better. And to keep trying different things to see what I can tolerate. I think I’ll go for a swim next week and see how that goes. I’m debating whether or not to run that by my PT first, or tell her about it afterward.

I asked if walking in bare feet is really bad, and he said it’s not bad at all and to go for it as long as it doesn’t increase my pain. I said my running shoes, which I’ve been wearing from the second I get out of bed until I return there, really bother my heel where they contact where I had the work done. So he said try sandals. I was very happy to hear both of these were viable options. I tried my Merrel sandals yesterday for a short time. Definitely not as supportive, but my feet enjoyed the breathing room. I think for now if I venture out into that uneven world I’ll stick with my runners. That’s my fear creeping back in. Maybe next week I’ll be braver! That seems to be my mantra!   Every new thing is scary, until I realize it’s really OK, and really not as scary as it seemed at first.  And then the next scary new thing comes along, until I try it for a few days and realize it’s not as scary either.  And so it goes.  I guess that’s progress!

Could I really be done with crutches?

I haven’t touched my crutches since last Thursday…5 days. Is it possible I could really be done with them for good? This is a big milestone for me. It took me 9 weeks.
My surgeon and PT say to continue to use crutches or one crutch or a cane until you can walk without a limp. From that, there are times I should probably still use one sometimes. And I will admit to clinging pretty heavily to the stair railing, or leaning on the backs of chairs, or tabletops, the edge of the counter, etc. from time to time. But once you set those things down, and feel that freedom, both physically and psychologically, it’s hard to pick them back up again.
I’m not sure if my ankle is better or if I’m just forcing myself to tolerate more pain. I think it’s a little of both.
I’m not ready to change my status here from PWB To FWB, as I feel I may jinx myself!! So I’ll leave it for now.   But I’m taking this milestone!  And hope I won’t be turning back!

A good day after a discouraging week..

Such a discouraging week I’ve had. I had a huge spike in pain last Friday, for reasons unknown, and I’ve been struggling to kind of get back on top of things since then. I’m still using crutches, but my surgeon and PT say to continue using them (both or one) until I can walk without a limp. I’ve had to modify some of my PT exercises because I just can’t do them, but at my PT appointment today, she said that’s OK, and exactly what I should do.
I have this overwhelming fear hanging over me that this is just going to be my ankle.  Forever.   I see so many people here doing so much walking so early on, and I just couldn’t imagine doing that.  I’m just trying to get through the day, doing regular things around the house.  It only adds to my fear that things are not going as they should be.  I know I shouldn’t compare my recovery to other’s.  I am not them, and they are not me.  With my ankle never really getting better after my surgery last April, I sometimes wonder if it even knows how to not be in pain.  But I keep trying to convince myself that that is not the case, and it WILL get better.

Yesterday was my first day of starting to wean out of the boot.  I was out of it for about an hour and a half, and felt OK.  Not great, but not horrible, either.  I was out of it at my PT appointment today trying out some new exercises.  She had me trying some balancing on a piece of dense foam and shifting my weight back and forth from foot to foot, with my eyes closed, but keeping both feet on the foamy cushion.  She looked over and I was standing there, completely on my right foot, left foot in the air, balancing away, completely zoned out, and she got so excited that I was doing that.  Then she realized my right foot is my good foot!!….I was just resting my rehabbing foot, cuz that s#*t is hard!!!  My left foot has exactly ZERO stability, but she did remind me it’s been injured, and not doing it’s thing for 2 years, AND operated on twice, AND NWB for 5 weeks, AND  in a boot for 9…

I went 4 km on the stationary bike, and got some new dorsiflexion stretches to do, and a couple of new balancing exercises to try.  So, I feel like today was a better day.  I’ll take ‘em when I can get ‘em!  My ankle definitely knows it did some things today, so I’m hoping it will be OK tomorrow.

Stay well everyone!

Slow progress is better than no progress.

I’m now 7.5 weeks post op, and I’ve just started dallying with walking without crutches. I started yesterday and lasted about half an hour, and today for a couple of hours. Then I have to go back to one crutch, and even 2 by the end of the day. But that’s improved from using 2 during the day and having to go back to NWB by the evening.  The hardest part is stopping when the pain level increases, and accepting my limits.  But it is so much easier to get things done with 2 free hands!  And not dragging around that perpetual dance partner!

I started physiotherapy a couple of weeks ago and have had 3 sessions so far. We started with measuring my ROM, which was pretty good. I could dorsiflex to neutral and plantarflex to 35 degrees. I have a way to go on both, but as a starting point they’re pretty good. I got some basic ROM exercises to do first, then we added some isometric exercises, and today we added some (almost) one legged balance, and gastroc  and soleus stretches out of the boot. So for the first time in 52 days, I put a regular running shoe on my foot. It felt weird. And wrong! All lumpy in the wrong places, and too tight on my ankle. And flimsy!

I’ve been wondering lately exactly what the purpose is of this boot that has become part of me. I know it’s for stability, but why?  How bad could my ankle be all on it’s own?  Well yesterday I absent mindedly went to the shower with only one crutch. When I got out of the shower, I one crutch walked without my boot, to the bedroom (literally 5 steps) and then back to hurry up and put that boot back on. Boy, did I feel that. Now I know the reason for the boot! My foot is as good as useless all by itself!  At my next physio session I’ll be getting some more out of the boot exercises to hopefully get a little more strength up before I start weaning out of the boot next week.

I feel like I’ve made some great progress, but at the same time feel like I’m still doing so little.  I know it’s a long process.  My surgeon did tell me that.  More than once.  He was right…imagine that?!

Promising 4.5 week follow up with the surgeon

Today was my 4.5 week (almost 5 week) follow up with my surgeon. He said my ankle looks great, and my ROM is already not too bad. Being in a boot for the past 2.5 weeks, instead of a cast, and being allowed to take it off and move my foot a bit, has helped.   His idea of “not too bad” and mine are apparently different!  It feels pretty stiff and tight to me. Compared to my other (and previously this one was too) super hyper-mobile foot, it’s not great, but compared to normal people, it’s probably not too bad!!

So I’ve now been given permission to start weight bearing (SCARY!!) with the boot, which I’m to wear for 4 more weeks. I don’t need to wear it while I’m sleeping if I don’t want to. He said at this point I can’t do any damage even if I roll over on it wrong.

Then after the 4 weeks I can start weaning out of the boot, or he said even sooner if I’m comfortable, until I’m back in 2 shoes again. I follow up again in 6 weeks, so we’ll see if I can accomplish all of this by then!

I also got the go ahead to start physiotherapy, and I have my first appointment next Wednesday (1 week from today). I’m going back to the same PT who I’ve been seeing since last April after my first ankle surgery. She is fantastic, I love her!! I’m excited to get started with PT - is that weird?!

He showed me my x-rays before and after so I could see the part of the bone he removed from the back of my heel, and where he put the anchor in to re-secure my Achilles’ tendon.  He said the tendon itself looked pretty good.  All good news.

I’ve tried to start weight bearing today, but basically right now I’m kind of just going through the motion of rolling my foot in the boot on the floor as I step. So basically, I’m touching the floor, but is there actually any weight there? I’m not sure. I find it kind of terrifying. I also get wicked needles jabbing through my heel when I put any weight on it. Hopefully that will go away soon. I’m sure I’ll get braver as the days go on.

I feel like I’ve made it out of the starting gate!

3.5 weeks and officially tired of NWB

So, I’m 3.5 weeks out from Haglund’s Deformity removal and the Achilles repair that goes along with it.  I’m officially tired of being NWB. Tired of not being able to carry things from one room to another. Tired of crutching my way up and down the 3 sets of stairs in our house. Tired of sitting on the couch watching crappy TV. Tired of all the movies in our DVD collection. Tired of the room I’ve come to call “the dungeon”, otherwise known as our family room. And really, just plain tired. It turns out not eating or sleeping for a week does a number on your immune system and I’ve managed to pick up a rotten cold. That coupled with post surgical fatigue has left me feeling, well, tired.  Too tired to do much of anything for any period of time.  And I’m bored.
I’m allowed to take off my boot and move my foot a little, and boy is it stiff. In every direction. I tried resting my foot on the floor (no weight, I promise!), in hopeful anticipation of being allowed to start bearing weight a week from now, and can’t even get it to the right angle to be able to stand on it. The dorsiflexion to neutral is just not there.

And I’m really bored.  Did I mention I’m bored?

Cast Claustrophobia is real…and it’s Terrifying.

I lasted 6 days in my full cast. Six of the most harrowing days of my life.  This is a difficult story for me to tell.

I never considered myself claustrophobic. Sure, I don’t care for the tiny tunnel that is the MRI machine, and you’ll never catch me caving in those damp, dark, narrow tunnels of West Virginia.  But generally, I always considered myself fairly well adjusted.

And then they put a cast on my leg. Not a splint, not just plaster on the back with a friendly elastic ace bandage holding everything together. But a hard, formed, never ending, all encompassing cast, that you can’t get off.  Can’t get away from.  Can’t get out of.  Ever. It started with nausea, then dizziness, then uncontrollable shaking and crying. And sleeplessness. Long, dark, lonely nights trying to figure out what was happening and how to stop it, how to busy my mind, how to focus on something else.  And failing.  Then panic. Frantic panic.  A racing heart, and such heaviness in my chest I felt like someone was standing on me, until I couldn’t breath. I could not physically suck in air.  Never have I felt so trapped.  So terrified.  So horribly wrong.   Finally, after 6 days of not eating, not sleeping, intense anxiety, fear, and a torturous wait for the weekend to be over, I made yet another call to my surgeon’s office, and with a little begging and pleading, and help from the most wonderful nurse, I am now in an air cast boot.  And with permission, yes, actual permission from my surgeon, to take it off whenever I want. Whenever. I. Want. I sobbed when that cast came off. Laid there on their bed, like a child, and sobbed. It was such an overwhelming relief.

So here I am, sanity intact, 18 days post op from Haglund’s Deformity removal and Achilles’ tendon reconstruction. Still NWB for 2.5 more weeks, but that, I can do.

For anyone who has never experienced this, you’ll think I’m grossly exaggerating. For anyone who has, you’ll know that I’m not. And I’m sorry. Sorry for the torment you endured.

For anyone who may ever stumble across this who is trying to figure out what the heck it is that’s happening to you, tell someone. Tell your family. Tell your friends. TELL YOUR DOCTOR. No matter how many times you’ve already called them, how many other complaints you’ve already made, no matter how much of a bother you feel you’re being, tell them. They can help you. They are health care providers. They went into this field to help people. They will help you.

First Follow-up; Cast #3

I had my first follow-up with my surgeon today, day 12, a week earlier than originally planned due to cast issues. The first thing they did when I arrived was take my cast off! Hooray! That thing was making my whole leg sting/burn, giving me pain in my ankle, the back of my heel and across the Achilles, and muscle spasms (not blood clots, thankfully) in my calf. So I was glad to have it off.
Next, I went for x-rays where they tried to gingerly move my foot around into various contorted positions, but it ended up hurting quite a bit.
Next was stitches removal time. My surgeon said my incision looks great, I agreed, and the stitches came out quickly and easily.
Then for the application of a new full, short leg cast, rather than the back plaster I’d had previously. I had the choice between waterproof or fibreglass, and they said the waterproof was lighter, so I chose that one. It had to be rolled on over my foot and heel and up my leg (like a giant leg condom!!) then I had my foot pressed into a fairly dorsiflexed position while it set. Not fun. Not fun at all. My foot is still slightly plantarflexed, but much closer to neutral than where it had been. So far this cast feels so much better. It’s lighter, thinner, and a lovely light green! Very stylish!  I’m in this one for 3 more weeks. Three more weeks of NWB. I’m fairly certain my surgeon left out this step when he was describing the road to recovery. Oh well, what can ya do?! It’s a snippet in the big picture of life. Right?
Today is also my one year anniversary of my ankle arthroscopy that started this mess. Honestly not where I thought I’d be one year out.