Moon walking again!

I finally managed to get in to see my surgeon a few weeks ago and had an x-ray. The screws and plate are hunky dory but the bones aren't fusing. So I've been put back in my manky moon-boot and told not to walk more than 5 minutes. These are my guidelines for six weeks and then I have a CT to see whats happening.

So I'm three weeks in and the pain can be quite extreme. Every time I lift my foot it feels like its separating! My back is also being effected because my work-boots and most of my shoes are a different heel height to the moon-boot so I'm thrown out with every step.

I want it to feel secure and the moon-boot doesn't do it. There's too much shift.

The cause of my non-fusing is basically my hyper-mobile ankle.

It rotates and bends so much that there is no chance of fusion. Most people are apparently so stiff that its not an issue but not me! I was thrilled because it looked like I had maintained enough flexion to cope with uneven ground whereas my ankle is held together by a couple of screws and a plate!

So now I'm waiting to see what the outcome will be and where I go from there.

I've look at the research and one of the treatments for non-fusion of an ankle arthrodesis is a tibiotalocalcaneal arthrodesis, which is what my original surgery was. So I will wait and see what the CT says and what the outcome is.

The pain! The pain!

I've been back at work for nearly a month and it is hard! I work as a Customs Officer so there is a lot of walking - airports are big places.

When I started back after 3 months off, I did 4 hours a day with a day off in between. Then I went to four hours one day and six hours the next. I'm now doing six hours a day for a shift of 6 days with 3 days off to recover. Next week I'm back to full hours. 

It's 17 weeks since my op and I was hoping to be feeling a lot better by now. When I was at home on sick leave I was doing brilliantly but now I'm back at work I'm going backwards! I limp really badly. I've read that I shouldn't (a similar problem to me) but I can't walk any other way. I wear big steel capped boots for work which should support my ankle but maybe they are too heavy and are putting stress on it. The problem is I cannot work if I'm not wearing them. I usually have pain sitting around 3-4 and always feel like my ankle needs clicking back into place. I can't get the pain down below this even with tramadol or naproxen (or both when I'm really desperate). I also can't take tramadol when I'm working.

Today I was doing stuff around the house and suddenly my ankle went up to 8 on the pain scale. I'm back to thinking an amputation sounds good 😆. It isn't swollen; it just felt like someone was trying to cut through it with a blunt pair of scissors. I had to sit down immediately. My husband got me my crutch, which I hadn't used since my cast was taken off. I hobbled upstairs and put it up. He suggested that I use both crutches and be non-weight bearing but when the foot is suspended it feels like it's just hanging by a thread of skin.

I've read a lot of accounts from people who have had the surgery in other countries and they seem to have a much longer time in casts and non-weightbearing. Everyone seems to have been in a cast, whereas I had the option of just being in a moonboot. I'm really nervous that I am doing damage or interfering with the healing because of my surgeon's quick return to weight bearing. It wasn't reassuring looking at the X-ray and being told it looks good but you can't really tell if it's fusing until the 6 month mark.

My work limits the aids I can use. I wasn't allowed back in a moonboot and I can't use crutches. Fortunately I'm able to do duties that involve sitting, avoiding the standing tasks. I'm feeling like I've lost myself really and wondering if it was a mistake to have the surgery. Ironically I am in so much more pain than I was presurgery and I am causing problems in other parts of my body because of the way the ankle forces me to move. My lower back often seizes up, my opposite hip that had had a steroid injection to reduce a bursitis is back to the same level of pain and difficulty lifting it and the cyst on the back of my opposite knee hasn't improved pain wise despite a steroid injection in it.

I tried contacting my surgeon to check up on whether I'm progressing normally but she was in theatre. Her receptionist said that she would pass on my message via an email that I sent but she doesn't appear to be the best with technology. I haven't heard anything and it's been a week so I'm going to have to chase it up, which I hate doing. The pain makes me irritable and I get more intolerant of people. I'm turning misanthropic and totally relate to Sartre's quote "Hell is other people."

So life is not being a bowl of cherries but I'll just keep hobbling along.

Freedom!

 I have waved goodbye to my moonboot. My ankle seems to be doing all the right things. I just have to make sure the stressors placed on it are not greater than the strength of the bond! Physics anyone!

My surgeon recommends I wear boots. My work boots are great and I have some casual Timberland boots but I don’t see them looking right if I’m going anywhere special.

My foot doesn’t feel like it agrees with the decision to free it. I have a very hesitant step because it’s having to learn to roll through itself instead of depending on the moonboot. I haven’t been given any physio. My only direction is no pounding for 3 months and do cycling to get my fitness back. I’m hoping deep water running is ok because it’s more my jam than cycling to nowhere.

I have another appointment in 3 months to check the final fusing has occurred although every time she’s looked at my xrays she’s said “It looks good but you can never really tell.” Words to fill me with confidence, not!

I find it interesting how recovery varies so much around the world. Same bones but so many different protocols and procedures. I found it a huge learning curve because what I had read up on about ankle fusion was different to what happened in my experience. I felt a bit like I was treading new ground even though I wasn’t.

Life in a moonboot

My moonboot has been my constant companion for six weeks. If you asked me to produce a right shoe, I would struggle. I am over the sound of Velcro ripping apart and the clomp of the boot as I walk. I was watching The Chilling Adventures of Sabrina on Netflix and the Dark Lord came walking into Dorian Gray’s and the sound of his one human foot and his one cloven hoof walking sounded just like me!

The levels of pain have varied. Two to four weeks after the cast came off have to be the most painful. Part of it was I developed plantar fasciitis after being in the cast. I didn’t know that it was plantar fasciitis, I just knew it felt like it. I would heat a wheat pack and wrap it around my heel and ankle to relieve everything that hurts.

Paracetamol was usually sufficient but I did take a tramadol a couple of times and a naproxen a couple of times. I am on gabapentin as a treatment for some of my MS symptoms so that had to help.

Despite finding the moonboot a chore I wasn’t really hindered too much by it. My work wouldn’t let me return to work until I was out of it because working for NZ Customs I need to be able to wear steel capped boots and react quickly in emergencies. So I’ve been learning French and getting lots of things done. It’s also made medical appointments easier to arrange, as well as vet visits.

I went on holiday to New Caledonia and learnt a valuable lesson. Do not get sand in your moonboot. I thought I’d dusted it all off but some remained and it rubbed really nasty patches on my leg. Not fun when you need to wear the moonboot that caused the rubs. I covered them with plasters and they started to settle down. While we were there I really tested out the capabilities of my moon boot. I went looking for a supermarket and managed to walk 15 kilometres! No real side effects until I did the sand trick.

I have found it really hard to be balanced while in the moonboot. I bought some trainers that seem about the right height and shoes with a small heel work great. I still manage to scrunch up my back and I’m having real issues with my lower back. I’ve had to have a few hot baths to get it to relax.

The scar still looks angry. It’s thick and red and sensitive. I’m hoping that it will shrink down and lighten up to resemble all the other scars in the same area.

It’s one day to boot off (hopefully). There should be a better indication that everything is bonded. I am so paranoid I am setting myself up to expect a repeat surgery. The skin around the joint burns like fire. It also feels like it clicks and even feels a bit unstable. I’m crossing everything that that will not be the case. I want emancipation from my moonboot.

2 days out of the cast

I’ve been making up a bit for being trapped at home in a cast. I couldn’t drive, the driveway was so steep and using a knee crutch on public transport was “interesting.” I did a complete pivot and fell once trying to get into a seat on a bus.

Being able to take the moon boot off to drive has meant I can get out of the house much more easily. I haven’t done anything major, grocery shopping and a visit to a cafe.

Pain wise it’s hard to tell. I have a very high pain tolerance so I tend to block out pain. My toes are no longer numb. I was a bit concerned about this when I was in the cast. It wasn’t tight but they definitely lost sensation. I can wiggle them quite happily. My foot is still swollen and the skin is really dry so it feels a bit strange wiggling the foot. If I try to circle my ankle when seated I get a sharpshooter pain on the outside at the bone. There’s no pain around my incision but when I walk my sole below it feels a bit sore. I also have a bit of pain at the back of my heel. It feels like a carpet burn. So not much pain really. I can walk without the moon boot, for example getting into the shower and I only limp a little.

My biggest issue is the moon boot. I’ve got a small but my calf is so wasted that when I go up and down stairs it moves up and down. Even with the pads placed on my calf it still gaps!

So far I’m very happy with the surgery and I’m looking forward to really testing it out down the track.

My foot is free (sort of)

Yesterday was my 6 week appointment with the surgeon. I’d read up on what to expect at the appointment and following. I knew that the odds were good that my cast and I would part company.

When I arrived I had the cast removed before xraying. It was so good!

My leg was like a hairy reptile! Plus it still had the arrow pointing out it was the right leg.

So now I was back on crutches but without the heavy weight of my cast. I had brought my moonboot because I was hoping I would be signed off on light weight bearing.

Once I’d been x-rayed I saw the surgeon. She showed me the x-ray but said at this time it was impossible to really know if it had fused completely and I’d have another x-ray and appointment in six weeks. It was interesting to see my other ankle bones with space between them and my fused ankle sitting flat on with its screws.

She said I would need to wear the moon boot when I was walking but I could take it off when I was sitting down, driving (yay!), showering and bathing and when I was in bed.  That sounded pretty much what I had read but the next thing was not! She said I could weight bear straight away. I could use crutches or a crutch if I wanted or needed to but basically I could walk as per normal. I put the Moon boot on and took a few steps and my calf cramped up big time! And I couldn’t pull my toes back to stop it. I used one crutch to support me a bit and that helped.

I was a happy camper, if somewhat surprised. 

The side view of the withered limb.

Looking at both my legs together is hilarious. I’ve lost so much muscle mass off the right leg. It is 5cm narrower in dimension than my left. I’m going to have to pay in some pretty serious leg work to get  it back to normal.

The difference. Both legs look swollen due to the angle!

The ankle movement is fantastic already, even with the swelling. The only moment I can’t do is what you would use for a side kick in karate and I’m pretty sure I can survive without that .

I was able to go out grocery shopping today, which was good because online shopping always seems to end with me forgetting to order something.

Below is a video of my range of motion. Enjoy!

 

The thing about using one leg

I have already talked about my poor left knee suffering under the weight of being the soul usable leg.

A couple of days after the ultrasound that definitely diagnosed my Bakers cyst, (which had ruptured and was separating my calf muscles!) my GP phoned. She told me what I already knew but was more inclined to refer me for a steroid injection than she had been at my first appointment. She put a referral through for an aspiration of my Baker’s cyst and a steroid injection.

I rang through to make my appointment. The receptionist said that they only had one radiologist on that week and he hadn’t done this procedure. Did I want to see him or wait until next week when the other doctors will be back on board? Ah, waiting please.

So today I went in for an ultrasound and treatment of the Baker’s cyst. The radiologist was happy to do the steroid but didn’t think aspiration would be necessary. So I had a nice shot of local into the top (not the back) of my knee and then he removed the syringe and put the steroid syringe on so no double dipping around.

So now I’m back home and of course it feels great because the local is doing its thing. I went from a 6 to a 2 on the pain scale, only my calf hurt. Unfortunately it’s going to wear off in a few hours and then it’ll take about 36-48 hours for the steroid to kick in. During that time period I’m likely to get my cast off so some light weight bearing might start so poor old lefty will have a bit less of a load to bear. It was naturally happier when I used my knee crutches rather than fore arm crutches. There was also no way it could propel me up stairs. It could not do the nice pop up.

I haven’t tried since the steroid went in. 

The other problem I encountered was I fell, a lot! My left leg would just go on strike. Most times it was no problem. I tried to step over a speed bump in our driveway and ended up sprawled on the ground. I had to take the crutch off, hard when you’re splayed, stand up with no support and put it back on.  No real injuries following that or any inside falls. The only damaging fall was on a bus, which was stationary. I pivoted around and crashed to the ground. In the process I managed to push my right knee sideways (a trick of mine) and sprain my right shoulder. Because I bruise easily anyway and I’m on aspirin I developed some lovely bruises. My shoulder is still sore but everything else is fine.