Broken Ankles 101
On January 25, 2012, in the blink of an eye, I broke my ankle in three places. Except for the broken bones part, it was the least dramatic event of my life. I have had more exciting trips to the bathroom. It happened in a fraction of a second, and has impacted my existence since that fraction of the second and will probably always impact my lifestyle to some degree. I am after all middle-aged, not a young pup able to heal and return to my lifestyle in a few months.
Around ten in the morning on that drizzly January day I was walking my dog, Kai. This day was just like all the others, except for the Chihuahua. He was your typical free-roaming Chihuahua with a Napoleon Complex. He was scared of everything, including me and my dog, until he knew my dog was tethered and couldn’t get to him. Then he was big man on campus, which ticked Kai off. That is when it happened. Kai made a lunge toward the Chihuahua, my left foot hit some slippery moss, slid for about three inches, then stopped on the gritty cement. However, the rest of me kept going. My left ankle folded over at about a 45 degree angle to the right. I heard a pop and then it snapped back straight. I dropped Kai’s leash, he chased the Chihuahua God knows where, and my ankle spoke to me in clear English. It said, “Get the hell off me. Get the hell off me right now.” So, I sat down on the end of the water-soaked driveway in a state of shock, staring at my leg. And there was no doubt in my mind that I had broken my ankle.
Kai decided to take his walk without me and proceeded to do so. (He’s darn lucky he’s cute.) I decided it was time to get out of the cold and into the house. I could put no weight at all on my left ankle, so I crawled up to the door over the cold, bumpy, wet cement. I was almost there when a wave of nausea overcame me and I had to stop. That was when Kai returned looking vaguely concerned because I was on my hands and knees. Not a single car passed by during this period of time nor did all my yelling at Kai to “leave the Chihuahua alone” rouse any neighbors to see what could be wrong. As I got to the door, I searched my coat pockets for my key . . . no key. I managed to raise myself up as high as I could until I saw my door key lying down at the bottom of the driveway where I had apparently dropped it. And, yes, I had to crawl back down there to get it.
Eventually I made it back to the front door with the key gripped in one hand and Kai’s leash gripped in the other. By the time I got into the house, my ankle was hurting and even the weight of my walking shoe was unbearable. Inside the house on my hands and knees I became a kind of sideshow for the cats who followed me from room to room until I got to a phone I could reach. I called my sister at work. Fifteen minutes later she arrived home, and though I protested that I couldn’t afford to have a broken ankle, she helped me into her car and we were on our way to the Emergency Room.
Of course, an emergency room is always a kind of sociological Petri dish and this time was no different. After waiting for an hour and a half, watching snotty-nosed kids with flu bugs, and adults vomiting into wastebaskets, the pain and self pity got the better of me and I started quietly crying into my lap. (My sister had gone home to get her cell phone as both of us hadn’t thought to bring one and she needed to contact her work.) A very kind man with his arm wrapped in a towel, asked me if I was alright and that made me cry even more, at which point, he walked up to the admitting desk and told the clerk that I was in a lot of pain and could they do something about that. Within five minutes I was being wheeled to the X-ray room. Shelley joined me in the exam room.
When the doctor came in she literally said, “Boy you really did a number on your ankle.” Using my X-ray as a visual aid, she showed me that I had broken my tibia, fibula and talus. The best they could do for me at that moment was to shoot me up with some serious pain meds and anti-inflammatory drugs, hermetically seal my lower leg in the swaddling clothes they called a splint and get me a referral to an orthopedic surgeon for the following week. (The delay in seeing the surgeon was to let the swelling subside.) I clung to the hope that there would be no need for surgery. Looking at the X-rays, I saw no egregious damage. As a matter of fact, I couldn’t find any of the three fractures that the doctor had identified.
They gave me an appointment card for the surgeon, and sent me home with pain meds, ice packs, and crutches.
By the next day, the pain really started kicking in. That was not a whole lot of fun, but what was worse, for the first time in my life, I started having claustrophobic anxiety attacks. Even my airy bedroom felt like the walls were closing in on me and it took every ounce of fortitude I had not to rip the splint off my foot and run screaming out into the backyard. For two days, I experienced cycles of claustrophobic anxiety. I wondered how long I could stand them. The problem with anxiety attacks – whether they last for 30 seconds or 30 minutes – is that every moment under their spell seems like – as Blanche Dubois says, referring to a dreary rainy day in New Orleans in A Streetcar Named Desire – “. . . a little piece of eternity.”
These attacks lessened with each passing day, and I later hypothesized that I had had a bad reaction to the dilauded that they gave me for pain in the emergency room.
Finally, I saw my surgeon. He walked into the exam room and unwrapped my mummified ankle to reveal five half-dollar sized blisters encircling my ankle just above the areas that were fractured. The doctor explained that they were called fracture blisters and they occur when there is soft tissue damage. The nurse lanced them and a fresh splint was put on my leg. The doctor pulled my X-rays up on his computer and said, “We’ll do surgery next Monday.” Then he politely excused himself.
So, on February 6, I was up at five a.m. and off to the hospital for surgery scheduled at seven a.m. The anesthesiologist gave me some “joy juice” before I was wheeled into the operating room. As far as I was concerned I would schedule a weekly surgery just for the “joy juice” part. But, too much of a good thing usually – at least in my own experience – turns into a bad thing . . . a very bad thing indeed.
After the surgery in which a plate and screws were placed on my tibia and fibula to stabilize the fractures, I woke up in my room connected to an IV pumping fluids and other goodies directly into my veins. I was also equipped with a blood pressure cuff, that little thing they clip to your fingertip that measures your pulse, temperature and oxygen saturation, and a Foley catheter. (Note on catheters: I love them. Never having to get up and pee when you are dealing with a lot of pain is to me, a tender mercy.) I also was on a plethora of drugs. In other words surgery was my friend and I loved it. Until . . . the anesthetic started to wear off. Even then the nurses made sure I had pain control when I needed it.
I spent the night there and the next morning I was scheduled to be fitted with a walking boot – in lieu of a splint or cast. Later in the afternoon I would be discharged home. My pain had been stabilized easily and I hadn’t needed pain pills for several hours. I was sitting pretty. And then, hours ahead of schedule, the “Boot Fitter” came into my room. Now, on an Orthopedic Surgical Unit, the general rule of thumb is to give the patient some prophylactic pain meds before any procedure that might induce pain. I didn’t know that then, but I sure do now. Pain management is numero uno these days and for good reason. But my orthotist crammed me into a boot which had two flat, sturdy steel supports that run up on either side of the boot to hold your leg in place, especially in case you trip or twist your leg. I expected some discomfort, but what I got was agony. And I mean pure, unadulterated agony. I rang for the nurse and she gave me some pain medication. When she checked back with me in twenty minutes or so, I was a convulsively weeping wretch. She checked to see what other meds were ordered and gave me a shot of morphine. Again, when she checked back to see if it helped, I was still in such pain that I couldn’t even form words. She kindly unwrapped the splint to see if something wasn’t fitting. Sure enough, both steel support bars were pressing against my ankle, rubbing against the incisions and pushing the staples further into my ankle bones. (The only way I can explain the level of pain this induced is this: imagine whacking your elbow, i.e. your “funny bone” really hard and then have that pain last for four hours straight.) The nurse removed the boot, and though it did not alleviate all of the pain, it cut it by about 75% and that was heaven to me. The steel braces were adjusted but even then I was scared to put it back on. That benign, inanimate velcroed boot had become a malevolent instrument of torture. But in order to have some mobility and be able to be discharged, I would have to wear it. I held my breath as the orthotist slipped it back on my foot, and sighed with relief when the pain did not return.
After the Physical Therapist cleared me to be discharged, my sister took me home. The five-minute trip from the hospital was exhausting and by the time she poured me into my bed . . . my comfortable, familiar, welcoming bed . . . I slept straight through from five p.m. until nine the next morning.
The first two weeks of my convalescence was a Percocet blur, which is probably a good thing because as soon as my pain let up and I was able to ease off the narcotics, I began to go just a tad bit stir crazy. Lying in bed I would watch TV. When that became unbearable I would watch my toes turn different colors. It was a toss-up as to which of those activities was the most mind-numbing. Of course, when I got out of bed the pain would shock me back into immobility. At that point, the self-pity, tears, and plaintive cries of “why me?” would begin. I’m unemployed, which means I’m uninsured, which means that when my bill comes I will probably need oxygen in order to read it without fainting.
A week after my surgery, I had a follow up appointment when I was told I would have to be “non-weight-bearing” for ten weeks instead of the original estimate of six to eight weeks. On top of the three fractured bones, I also managed to tear the ligament that braces my tibia and fibula at the base of my ankle. Though bones heal in six to eight weeks, ligaments heal much more slowly. Besides that, the bones in my foot were osteoporotic. Osteoporoses? Really? I suddenly felt really, really old. The good news is that calcium, magnesium, and vitamin D supplements, as well as exercise when I’m released to do exercise, should reverse that condition significantly.
Last Thursday, I had another checkup. And because I’ve been diligent about stretching my ankle muscles and doing pretty much as I’ve been told, I may be ready to start “bearing weight” on my broken ankle sooner than expected. Next appointment is at the end of the month. I cannot wait.
Everything is a learning experience and I would like to pay it forward a bit. My one piece of advice is: Be your own best advocate. Don’t suffer pain in silence. Pain meds are available and should be used.
Clichés become clichés because they are so often apt. So, bear with me as I indulge in some right now: If you’ve got your health, you’ve got everything. And . . . be grateful everyday that you can take out the garbage, scoop the litter box, walk your dog, and carry a glass of water from one room to another. I cannot wait until I can carry a glass of water from one room to another. I also don't know what I would have done without my sister. She made sure throughout my convalescence that I had everything I needed to make me feel comfortable and cared for. I will be more patient and tolerant with others now. Some people live with handicaps their entire lives. At least mine is temporary.
I know this much: You don’t really know what you’ve got until you lose it.