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.

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.

I’ve done much and blogged little

My orange cast was so uninspiring. I googled ideas to decorate casts and saw a few using Ironman. My Marvel hero is Captain Marvel so I decided to paint my cast as her boot.
I even managed a visit to the movie to check for accuracy.

Painting an half leg cast is a bit of an exercise in flexibility. I decided I’d paint it as bursting out of my cast. I thought I had acrylic paints but I had watercolour. I thought it would be fine if I sealed it. It was a mistake. The leg bits were fine but the black sole was a recurring nightmare. I couldn’t reach so I got my husband to do it and he was very diligent and painted it nice and thick so no orange showed through. I sealed it but the problem was some areas were still wet underneath and they squished out and I left black marks everywhere my foot touched - the bed sheets, towels...

It was ok but not what I really envisioned. So I bought some paint sample pots in red, blue and gold. Yes that’s right my black paint was a problem but I did not buy black paint. I don’t know what I was thinking. Maybe I didn’t want to have to ask for assistance so I left it out.

The result was much better.

Even the black started to behave after I sealed it all again. That was until I really needed a bath. I knew I could use my cast protector in the bath. All I had to do was equalise the air by opening the seal when the cast was under the water. Yeah, about that, make sure the back of the seal is not under water. A small bit got through. I noticed it in the top corner by the seal and pulled my leg out of the water, threw it over the side of the bath (like I should have done in the first place. Little grey drips fell from the heel and the lining at the top and bottom felt damp. A very long session with the hairdryer on the outside (not top hot setting or you will sizzle your toes) and it was good as new. No dripping black since and no squishiness inside. 

Time keeps on ticking...

After clomping around a week I had my bandage removed to check what was happening.

The wound looked really good. There was no sticking to the dressing like when I had my calcaneal osteotomy so that was a relief. The external stitches were removed and the rest are dissolving stitches.

The nurse told me that my surgeon would come and look at it and then I could put my moonboot back on. Horrors! I did not want that heavy, hot unwieldy thing on if I didn’t have to. It looked ridiculous wearing a moonboot and a walking crutch. I said I’d been expecting a cast. The nurse said to tell that to the surgeon....and I did. Got my cast! The nurse then told me only the patients who can be trusted to follow instructions get offered the moonboot option. I took that on board - I’m a trusted patient 💖 and then I got my cast put on! Not as bright as I’d have liked. She was out of all Fluoro colours sadly.

When she checked my foot the surgeon moved the ankle nicely up and down. That was reassuring. While the cast was being put on I had to keep my foot at right angles to my leg and push my toes flat. My toes don’t do flat they do a weird curling so it was a real mission getting the foot just right.

I had to use crutches to leave because the knee crutch might dent the cast. This was not fun, I couldn’t seem to get the motion right. I was glad to get to the car. It was nothing like when I’d previously had crutches. I struggled around at home and then decided I’d google how crutches should be adjusted. It turns out the crutches that the nurse thought were a perfect height for me were way too high. No wonder I was literally leaping around. I adjusted them correctly in anticipation of my next journey.

Unfortunately even with the correction of the height I still struggled with the crutches. I tucked them in the corner of the room for emergencies and went back to solely using my knee crutch.

I have only summited our driveway three times since my surgery. The first time I used my crutches and my knee crutch and resembled some sort of mantis like creature. The second time I weaved

 backwards and forwards and it took forever. Then it came to me - use your walking stick! I set out on a trip to the train station to check I could get there for work and then to have a nice lunch and maybe some shopping. There are two very steep walkways to the station but with my walking stick I made it relatively easily. Success! I had lunch and walked home. Halfway there I suddenly remembered to hold the grip on my knee crutch when going up and down hills and it will be no problem. And so it was! After lunch and shopping I was able to put my walking stick in my bag and trundle home. I was thrilled by the fact that I beat an old lady to get up the hill.

It’s the small things that make your day! Now I just need a tripping hazard sticker and maybe a safety flag for my foot!

I’m being fused!

I’ve made it 4 years, 7 months and 4 days.

I’ve made it over four and a half years post calcaneal osteotomy. Four years were pain free but the arthritis started to win the battle. I’ve tried to brave it out because I don’t want to give up my ability to run. I was told when I had it performed that eventually I would need an ankle fusion.

I’m at that point, in fact way past that point but I don’t want to go down that track. For me the pros are far out weighed by the cons.

Ankle fusion or arthrodesis involves cleaning up the ankle joint and fusing the bones together with screws, plates and bone grafts. Sounds easy enough?

New York Marathon 2018

• Well, it means limited range of movement - I have two flash hip joint prosthesises so I can run so they’d be wasted.
• It can change how you walk which can lead to, you guessed painful arthritis in other parts of your ankles, knees and feet! 
• Recovery can involve 10-12 weeks in a cast. Mines my right side and we drive on the left hand side of the road so my right foot is responsible for the foot controls. Therefore no driving. I work odd hours and can’t take public transport so no work or pay for 3 months.

This is the only likely option if I use our public health system, as I did with the original surgery.

My surgeon also works in private so that gives me more options. She does ankle replacements. 

• It has a shorter recovery period - 3-6 weeks in a cast.
• You regain a wider range of motion. Apparently most people return to active lifestyles but that would depend on your definition of active lifestyle.
• Return to impact sport is rarely possible.
• Need to have little or no ankle deformity - who knows if the CO has made it so!

So this is better than fusion but still unlikely to let me run unless the surgeon is brave. I’m waiting to get an appointment. If I went down this road I’d want a mobile bearing replacement rather than fixed. I don’t even know if that’s an option in New Zealand.

So what do I want? At the moment, a sharp knife and a ton of local anathestic! It is the most pain I have experienced in my life and I have experienced some high level pain. I also have a very high pain tolerance level. Right now nothing even reduces the pain to tolerable. I am taking Naproxen, paracetamol and lots of tramadol and it’s like I’m eating lollies. I can barely walk. The lowest levels of pain occur when I’m wearing the steel cap boots I have to wear to work because it’s really rigid support. Still painful but at least I can carry out my job.

It is actually something I am considering (not the DIY method!) but seeing where non-traumatic amputation for severe osteoporosis-arthritis falls on the scheme of things. I have friends who are amputees so I know all about stump issues and prosthesis fittings being hit and miss but the pain is really driving me mad and not being able to run after all I’ve been through to guarantee I can continue to run after two hip replacements is making me want to scream “Chop it off and just shove a blade on it!” Plus there’s the whole leg length issue. I was lopsided when I only had one hip replacement and that caused back and hip pain until I was straightened out with the second one. I don’t want to go down that path again.

So I wait to see when I get an appointment - how much longer I have to suffer in pain. Then I will ask for ALL the possible options and see where that leaves me.