Broken ankle stories from a king sized bed.
Coping with pain, boredom, fear & recovery from an August 11, 2011 ankle fracture.
I owe every person who has ever had a broken ankle, leg, foot an enormous apology! I am one of those people who would see someone with a cast on their leg or foot and think, "Oh too bad! Good thing it's only broken, you'll be up in no time." I am ashamed to say I thought & maybe even said this out loud to my friend Ann when she broke her leg. Ann sent muffins on my first day home with orders that they were for me only. Recollecting my previous asinine comments...I felt certain a lethal dose of arsenic had made it's way into her usually scrumptious muffins! I believe this would be referred to as "just desserts" and in my death throes, when asked who the culprit was, would have pointed the finger directly at - not Ann- but myself!!!
I have given birth a few times without any drugs and thought I had reached the pinnacle of pain. We women were bloody superheroes for doing that (I still believe that, by the way!), even my husband agreed! Everyone I knew agreed...
I obviously did not know many people who had fractured an ankle, leg etc. and as you can see from my comments above; I would have entirely dismissed their simpering as a weakness in their character anyway!
PLEASE FORGIVE MY ARROGANCE & IGNORANCE! A broken ankle is by far the worst pain I have ever endured and I am not alone in this! There are countless blogs and Q&A sites on the internet devoted to the hell it is and it just gets worse! They just keep piling insult upon insult upon said injury! I'm not kidding and (unlike myself) I am not even being dramatic about it. I have also learned more than I ever hoped to know about recovering from a broken ankle and (unfortunately) how long it takes.
The weather started getting rough, the tiny ship was tossed!
August 11, 2011 - a day I was so looking forward to! I had just returned from a working vacation in SE Utah and was joining my family at my husband's parent's cabin on a tiny island in Howe Sound off of mainland B.C. It would be the first time since Christmas that my husband and I and all six of our kids and their significant others would be together. Finally, an opportunity to enjoy the mayhem & madness that ensues when we all gather and to get a summer family photo done instead of the usual Santa's knee catastrophe. To add to the fun; our friend , Blanca was here from Mexico and her partner and our good friend Denis had joined us for the weekend. What could be better?
The last of our bunch was set to arrive the following morning so Blanca, Denis, our youngest daughter Lili and I set out for a morning walk on the paths that crisscrossed this mini paradise. About 100 yds from the cabin, we decided to take the lower path and started down the hill. I decided to do the "crab walk" at the last part due to the incline, some loose gravel, I was in flip flops and the fact that I am not exacly a light weight. I was getting close to edge and saw one of the other islanders coming our way in the golf cart we use to transport gear from the dock to the cabins and realized I would end up directly in front of him if I went any further in that moment. I put my left foot back and it started slipping so I put my right foot back and immediately the pain dropped me to my butt! Thinking I had simply sprained it badly; I put my right leg down and scooted backwards on my butt. I looked down to see a bone, just beneath the skin and located in an area I was quite certain a bone should not be. A cold sweat took over as my daughter took my hand and our friends did a closer inpection of the damage. Frank (man in the golf cart) stopped to say "Hi" and soon discovered my dilemma. By now, the pain was really setting in and I was pissed that our weekend was coming to an abrupt end before we had even started! Before I knew it, 5 (?) of the other cabin's inhabitants were trying to figure out how to get me from where I was to where I needed to go- aka the hospital. My memory gets a bit dodgy here but I think they tried to carry me first. This was a very bad idea as it left my ankle dangling in the wind and the first (of what I am sure would be many) screams leapt from my throat! Plan B was to chuck me in the back of the golf cart, but with no bracing around my ankle and the many potholes that dotted the path, this too was quickly nixed. Plan C was a large wagon with a foam mattress. This worked well until the next pothole. Someone suggested splinting my ankle and soon I was wrapped in two cedar shingles and a tensor bandage soon to be followed by a very long board under my entire leg and tied with a lovely yellow rope...and a brief moment respite from increasing pain. Halfway to the dock, someone called for air/hydrofoil rescue but realized it would take less time if they could get me to the mainland by boat. They called my husband who was already on the mainland and at the marina with his brother fixing another boat. The ambulance would meet us there.
I have no idea how long it took to get me to the ramp that extends to the dock below but I was aware enough to know it was low tide and the ramp was at a 45 degree angle! Panic started to set in as visions of flying down the ramp and into the water looking like a trussed turkey crossed my pain addled brain. In that moment as in no other, I wished with all my being that I weighed less than I actually did and that they would be able to guide that wagon safely down the ramp to the boat! I held on to each brace on that ramp until my nephew finally convinced me that i really needed to let go if they were going to get me to the boat. We reached the dock, thanks to all those strong determined hands. As i was being lifted into the boat I heard a far off scream. In an instant, pain like never before shot through my ankle and I realized that far off scream was actually coming from me. Not until much later would Blanca tell me that whoever was holding my leg up on the board had lost his grip and my leg had gone crashing down to the surface of the dock! In retrospect; I feel so sorry for that fellow. He must have felt terrible!
I was in the boat and on the way. Small boat + broken ankle strapped to a hard board + wind and water do not = a pleasurable afternoon outing! I tried to concentrate on something other than the excruciating bouncing of my leg and started repeating something my great grandmother used to say to minimize any type of dilemma..."The sky is blue, the grass is green. All is perfect in the world." That went pretty well until we hit what felt like (and no doubt was not) a large wave. ALL WAS NOT BLOODY PERFECT IN THE WORLD!!!
I heard my husband's calm reassuring voice and felt sure I was over the worst of it. Once in the ambulance, I promptly passed out and was beyond irritated when the attendant forced me back to reality. They gave me NTNOX (Laughing Gas) during transport and in as much as it was helpful during labour and delivery with my son, it was of no use to me now. We arrived at Lion's Gate Hospital Emergency where my ankle was x-rayed and I was given the first of what would be many shots of Morphine. To say I was grateful for being loaded with opiates is truly an understatement.
Through the fog of morphine, I heard the surgeon tell me I had made quite a mess of my ankle and they were going to deeply sedate me in order to help line up & splint the fractured (read plural) bones. I was stunned to hear he would do surgery once they got the swelling down a bit, and then everything went gloriously, silently black. When I came to I was in a bed in the Orthopaedic Ward. Our oldest son was there to pick up his dad after I had assured them I was going to stay in this morphine induced bliss for as long as humanly possible and there was no need to stay and watch me snore. I was so sad to miss the weekend but would have been sadder still if the rest of my family had not carried on carrying on. I was content to be alone with my new best friend "Morty" Morphine.
Countdown to surgery - ...and it just keeps getting worse
" There is a bimalleolar fracture present. The fracture seen through the distal metadiaphysis of the fibula is displaced laterally as well as posterior by about 1cm. There is also some impaction as well as mild apex medial angulation.
The fracture involving the medial malleolus is commuted and displaced medially and slightly distally. The ankle mortise is disrupted with lateral sublimation of the Talus with respect to the tibial plafond." "English please?" I request "You have broken every bone in your ankle, crushed the end of one of them, dislocated a few as well as some ligament damage. Don't worry. They lined up well when we splinted it and the surgery will fix it up nicely. It says here you had a stress factor in the same foot two months ago and you were to have a bone density scan on Monday. Is that correct?" "Yes" I responded "Will you be able to tell if I have osteoporosis during the surgery ?" "No, you'll have to get the scan done at a later date." And that was that. And there it remains until ...whenever. The doctor must have told the nurses to keep me lucid for that short span of time.
I could not believe I had done that much damage to my ankle by slipping on a piece of loose gravel. I also could not believe the amount of pain I was in. I just wanted to sleep and every minute I was not made my mind whirr with anxiety. Every simple movement we take for granted became an unknown and unwelcome adventure in pain. Crossing my ankles was not going to happen. Hoisting myself up and balancing over a bed pan on one leg was proof positive that Tai Chi just might be my thing. When no one came to remove the bed pan; I learned how to disengage my arm from the railing that was helping me to balance while detangling the IV tubes and then removing (without spilling) the bedpan to a small table next to me, without moving a muscle in my right leg. I did not resent the nurses for not coming back quickly enough. The call bells could be heard 24/7 in the hallways as other patients vied for their time. Once they knew I had mastered this particular skill, I was on my own.
The nurses warned me that morphine often creates an itching sensation on the arms & body and to let them know if that happened and they would add Benydryl to the cocktail, As the next dose hit my veins; it was not my arms and body that itched. No no, not me. It was my nose and my crotch that became unbearably itchy! All dignity was now lost as I fell into a drug induced stupor while splayed over a bed pan clawing wildly my nose and undercarriage!
It was in deep darkness that I awoke screaming in pain. I was having the first of what would be many muscle spasms in my right calf and ankle.
The pain was excruciating and that it had woken me from a sound sleep made it even more frightening. I was terrified to go back to sleep but soon discovered the spasms were not fussy about timing. They came at all hours of the day or night without regard for morphine, benydryl, antispasmodics or any combination thereof. For the nurses, it was a shruggable offence not worthy of investigation beyond how many more cc's of morphine it would take to knock me out again. "Do you take pain killers at home?" the head nurse asked "What for?" I replied from somewhere behind the liquid curtain. "Headaches...the usual." now she was just annoyed. "Nope...I don't get headaches." "Well, you can certainly suck up the morphine!" she exclaimed as she left the room. "Suck up the morphine"...I am sure I remember that simply for its lack of medical jargon/ professional speak.
Osteoporosis was raised a few times but I honestly did not give it much thought. Getting through the days and nights while be stalked by ever worsening spasms seemed to be taking up the bulk of what little was functioning in my brain at the time. There is no history of it in my family. I eat well (ok-too well!) and take calcium supplements. I'm betting on this being a nasty accident. But I will keep you informed.
I don't know what time they came to get me for surgery. I just knew I was glad the time had finally arrived. I woke up to a nurse smacking my cheeks and calling my name. " Kate, Kate, Kate do you take any pain killers at home? ." "Why do you people keep asking me that?! No I DON"T! Geezus-just let me sleep! Please! "Kate, you're not breathing properly and we had to give you some NARCAN. Take a deep breathe for me. You're going to be pretty tired but you'll be fine in a few hours...just keep breathing nice and deep..."
Are you kidding me? They have overdosed me on morphine, then tried to reverse it with Narcan and they want me to be cognizant enough to manage my respiratory functions and the worst part is ...they woke me up to tell me this.
The surgery apparently went well and I am in a cast with an opening at the front. I see blood seeping around my toes due to the Heperin they gave me to prevent clotting, but for the first time in 36 hours, I do not feel like someone is drilling into my ankle with a red hot poker. The nurse tells me they gave me something during surgery that would keep me pain free for about twelve hours and to make good use of that time by sleeping unassisted by drugs. I have a bed next to the window overlooking the lights of the city and Burrard Inlet. Best of all, there was a breeze coming through the window and I could taste the salt air on my lips. My leg was put back together and all I needed to do for the next few days was recoup and rest in what could have been an extremely over priced semi-shabby hotel room with a killer view! How bad could it be?
Halfway through my twelve hour window they gave me a roommate...a very high maintenance room mate. I am convinced she crazy glued her thumb to the call button; it was on 24/7 along with her cell phone...and she could wail on cue whenever a nurse was within ear shot. It was impressive. I hope she got what she needed. I am very grateful to that woman because she, more than anything else, motivated me to do everything possible in order to go home!
I started using a walker to get to the bathroom the day after surgery. The first time I used the walker, I moved too fast and almost passed out from the pain. All the blood rushes down to the injury and does not get pumped back up as fast. My toes went a deep purple colour and my leg felt as though someone had attached a cinder block to my foot. I learned quickly to swing my legs over the side of the bed and just wait a few minutes before walking to avoid that rush of blood and the ensuing pain. It still hurt...it was just dragged out a bit longer to make it less intense.
I had two more things to master before I went home; negotiating stairs on crutches and pain management. A no nonsense Physical Therapist came in shortly after I had been given a dose of morphine and demanded I get on those crutches and up the stairs. I told her I had just been given painkillers, she responded that was a good thing, "It will hurt less if you fall." Not joking...her exact words. Anger was beginning to percolate in me from lack of sleep, pain & the 3:00 am phone calls my room mate would make in order to yell at her boyfriend and it was anger that propelled me up those stairs and down again! Pain management was less complicated. I had never had to ask for meds. The nurses came like clock work every half hour so and I began by refusing every second top up. Two days later, I was down to every five hours and managing pretty well. I could go home.
Ken arrived to get me and plopped me in the back seat with the front seat laid out flat to support my leg. Stress affects me in three ways: I sleep more, I throw up, I develop cold sores on my lower lip. I managed to do all three within an hour of leaving the hospital. Our house is not disability friendly. There are stairs to get into the house, stairs to the kitchen, stairs to the garden, a step down to the living room, stairs to get to the laundry room....My house is a minefield of stairs! I was somewhat relieved my surgeon had said to keep my leg above my heart (ie: stay on my back in bed with my leg raised) and my only exercise was to try to wiggle my toes. I have never felt so vulnerable in my life. Once home, I saw a million things I wanted to do and couldn't. My husband was on holidays and able to take over the cooking and watering of the garden and when he couldn't be home our daughter was. My husband lovingly tells me I am INVALID! Nice.
Previous to my injury, I led a busy life. I worked, looked after the house and garden and my family. Post injury...I have done diddley squat and I was certain I would lose my mind. I read fast and went through four books in four days. I watched old movies on TCM and did some paperwork from my bed. It has taken three weeks to settle down and accept that this is my life for a while. Ok...maybe "accept" is too strong a word. I am working hard to get all my toes moving and my ankle to lever up and down and anything else to keep me from going stark raving mad!
adding insult to injury!
August 26th, we have an appointment to get the cast and the staples in the incision removed. Did I mention my house is a minefield of stairs? The hospital I had surgery in is an hour from my house. It was conveniently located to the island, but not so much now. The appointment is smack dab in the middle of rush hour and in order to get there in time; we get ready to go an hour early. Thankfully, Ken has found a shower seat that makes bathing a whole lot easier, and a walker and crutches to help with mobility. I get showered and dressed and get onto the crutches while Ken loads the wheelchair into the car. Our 25 year old daughter Gillian stands by as I manoeuvre myself down the hall to the front staircase.
It had never occurred to me that we do not have a banister all the way down the front stairs - it does now! I gingerly place my crutches on the stair below me and lift my leg off the floor in readiness to make the second step. Gillian hangs on as I launch us both to the very bottom of the stairs! I had just enough time to try to position my leg for the least possible impact. My hip hurts and poor Gillian is clinging onto me, yelling for her dad. Ken pushes through the people pile and gets me off the floor. He looks concerned but both Gillian and I have come out relatively unscathed. We have two more flights of stairs to go before we get to the car. I am totally unimpressed.
We ditch the crutches and Ken retrieves the walker from our bedroom. He braces it against the steps and I manage to make it the rest of the way without incident. It is the last time I use crutches for sometime.
We arrive at the hospital just in time and I am whisked of to x-ray and back to the cast room. The nurse arrives and says everything is still where it should be and removes the cast. I am entirely unprepared to see a black, blue and red mottled and swollen leg and foot with a row of silver staples running down both sides of my ankle. It does not even feel like it belongs to me. I am shocked...so is Ken. I ask the nurse to close the curtain as I did not see this as a spectator sport. Nurses and doctors seem inured to other's discomfort. The nurse wipes down my ankle and removes the first staple. Not bad, really. As she reaches the fourth staple I tighten my grip on my husband's hand and break into a cold sweat. Apparently I am still very swollen and says she "has to dig around a bit" to snip them off and remove them ( as you can see from the photo above, she had to use steri strips to re-close the incision, which took another week). This continues until all 38 staples have been removed. I want to scream but there are people outside the curtain and I increase the pressure of my grip on my husband's hand instead. The minute she is finished, my husband lets go of my sweat drenched hand, runs to grab a tray (he knows me well) and I throw up. Had I known what that was going to entail, I would have dosed myself up on painkillers before hand!
I cannot believe they did not offer something up when they saw the swelling! I was soaked in sweat, traumatized and righteously pissed off! The doctor arrives, moulds my leg and foot in a fibreglass back support and wraps it with a tensor. He says all is healing well and to stay prone with my leg raised as much as possible for another six weeks. I ask him to refer us to a surgeon at our local hospital and off he goes. Good surgeon-good nurse - bad bedside manner. I am so relieved to have that entire day behind me. Once home, I sleep until the next leg spasm wakes me up.
This sucks wind!
"That looks great"
...and other stupid comments
I finally posted photos of my ankle on FB. I was getting very tired of people telling me I would be back to work in a couple of weeks and that it was no big deal (exactly how I thought before it happened to me!). I also get a kick out of people saying things like "Can you imagine how much worse it would be if it you broke your back?" No-No I can't imagine how much worse it would be if I had broken my back - Just like I could never have imagined what it would be like if I broke my ankle! My latest all time favourite is "Your poor husband-he is doing everything right now!" Yes-yes he is-just like I have done for the last 30 odd years and would love to be doing right now and would do exactly the same for my darlin' husband if he was in the same position! There must be a Catholic Jew that lives inside of me...All right already!...I feel guilty for lying around doing nothing all day! My father had a saying..."If you want sympathy; look it up in the dictionary...right between shit and syphillis." Geez...I think I need new friends...and family! LOL
Mending slowly but surly (no that wasn't a typo!)
and counting my blessings
It is now the end of week four. I have 4 more weeks to go before weight bearing. The swelling has gone down considerably and I can move two of five toes on my right foot. I can "lever" my ankle up and down about 2cm's but any ROM attempts are met with a biting pain in my ankle. I can feel where the long screw went in on the inside of my ankle and the plate on the outside of my ankle. I feel them all the time. I have had two opinions from two doctors about keeping the plates in or having them removed once I am healed. One says leave them in, one says get them out within the year. I will have a third opinion when I meet my new surgeon in four weeks. I can't abide the thought of leaving them in but with the last surgery and staple removal fresh in my mind...I can wait.
My husband and youngest daughter are back at school. Gillian is heading off to live and work in London, England in six weeks but for now, I have the pleasure of her company and she takes brilliant care of me! Thank-you darling! I'd love to say I enjoy getting breakfast in bed and being able to ask for water and having someone to change the sheets every couple of days, make meals, do the laundry OK - I DO LOVE IT! I am beyond grateful for it. I am livin' the dream ...it's just that... in that dream...I didn't have a broken ankle and it was not a beautiful young woman serving me breakfast in bed...c'est la vie!
I have been able to finish up some paperwork and reorganize our website from bed, which is good, but the bulk of my job requires me to drive and carry a heavy case while going into private homes to do assessments. I have had to stop reading broken ankle blogs because they all say it has taken at last seven months before they could walk without canes and go up and down stairs normally. As a self-employed person; I am not entitled to any benefits nor do I have disability insurance. I do have a terrific family and a husband who makes a good living. We will have to be careful, but we will be fine.
I have a friend who calls me everyday. Between her and her brother; I get to laugh before some people get out of bed in the morning.
We have a great circle of friends both near and far and they let me know I am loved and thought of.
Little things that bugged me don't anymore. I have managed to find other, equally small things to bug me even more! Like Thatcher, my daughter's house rabbit. Our entire house has been rabbit-proofed except our bedroom. Thatcher hops in for a visit and I can't shoo him out when I am alone so, after we make eye contact, straight under the bed he goes to chew on the iPhone, Macbook and iPod cords. Must be because they are all Apple products. I need something creative to do that won't mess up the bed.
I still get the painful spasms in my leg but only at night and usually just as I have fallen asleep. I have a bag of drugs on the table next to me that my husband refers to as my "candy store." I only take an anti-spasmodics at night but its good to know the rest are there waiting should I need them. Kind of like pharmaceutical stuffed animals really. Along with the spasms are the little electric shocks and burning along the incision line. I am now starting to get sensation back into areas of my ankle and foot where there was none after the surgery. This teaches me that some discomfort can often be a good thing.
I will write less now as one day flows into the next without much change. I will write when something does change and after I see the surgeon. I have a bone density test next week.
Take care all and let me know how you are doing. We can commiserate...or tell bad jokes...either will do nicely.
Great...now when people open my blog the top ads are for drug recovery...seriously folks...take a pill.
I get by with a lot of help from my family and friends
Week three since I broke my ankle. I am sure the swelling would have gone down considerably on its own but I know it went down far more rapidly with the help of a friend! Donna came over at the three week mark "loaded for bear"! She brought oil for massage, comfrey root (enough for four poultices), Japanese Peppermint oil, Homeopathic Eupatorium, Arnica & Comfrey, Calcium/Magnesium Liquid & CalPhos Tissue Salts! She ground up the comfrey root, made a tea with the leaves then added the tea to the ground comfrey root to make a paste. Donna then slathered the paste onto my foot and ankle (avoiding the incisions) then wrapped it with gauze and left it there for an hour.
Many people view homeopathic, naturopathic and herbal medicine with skepticism (to outright disdain). Personal experience has proven otherwise for me and is usually my first line of defence for things like flus, colds, sprains, ear infections etc. I think we overuse allopathic medicine for simple things that can be dealt with using our local weeds. Obviously a broken ankle requires far more than our local weeds and as you already know from reading my previous entries; I have had no problem using all available resources (and drugs) to tame this puppy!!!
After scraping off the comfrey poultice (and a goodly amount of dead skin!), it was immediately obvious that much of the swelling was gone. Donna gently massaged my foot, ankle and calf with calendula oil. There were still areas that were completely numb and although I felt pressure; there was no other sensation. I was very nervous about anyone going near my ankle, but she was very gentle and knew exactly where to go and more important - where not to go. Donna massaged for three hours! It is the only time I have been able to move all of my toes since the "incident". Even now, I can only move two toes. My shin was still tender from the dislocation and that is the only place she used the Japanese Mint Oil. I have no idea if it did anything other than cool it off a bit-but the massage was AWESOME! We applied the comfrey poultice every day until we ran out (four days). Each time the swelling went down a bit more and each time, I was able to move my foot up and down a bit more...not a lot...but a little.
I will be grateful to Donna for the rest of my life for that day of nurturing and healing touch! I am quite certain I would not have let anyone else near that ankle without the training and experience Donna has. THANK-YOU DONNA! Nurturing, loving touch is highly under-rated, so for anyone reading this who is not injured...offer a simple calf massage and some TLC. It is not something we will ask for, but is greatly appreciated when offered!
Yesterday marked the first time I had left the house since I fell down the stairs. Getting out of my house is simple now. Getting back in is a whole other story!
moving toward normal
I had my six week check-up with the new surgeon. They will be taking out the long screw in November. Apparently this long screw always breaks and then they have to go in and fish it out from inside the bone which sounds like something I absolutely do not want to have happen! The bones have healed very well and there is no sign of Osteoporosis - Yippee! Due to the dislocation of the Talus; physio will be neede for a couple of years and there will be swelling and stiffness for a very long time.
I have been going to physio and doing the exercises religiously. The change has been nothing short of marvellous! From being in bed 24/7, I began to use crutches and an Aircast - putting more weight on my ankle each day. By Thanksgiving (October 10th in Canada), I spent the day in the kitchen getting up close and personal with a couple of turkeys without using crutches at all and only an aircast. We had 14 people for dinner and I survived! Today reminded me not to do that again for some time. My ankle - especially the achilles tendon, was pretty uncomfortable all day today and begged to be iced. I will return to work on a part-time basis next week and am nervously looking forward to it. We went to our daughter's university graduation last week and I still feel pretty vulnerable "out in the world."
Breaking my ankle and spending six weeks in bed has been an experience I would not want to repeat - and yet there have been many many blessings that have come with it. After the initial trauma and the spasms during the first three weeks, things steadily improved and I learned a few things I would like to pass along.
1. If you are told to stay in bed with your leg up -DO IT! Do it because you will heal so much faster and so much better than if you feel compelled to push yourself.
2. Let yourself enjoy and appreciate your friends and family rallying around to support you.
3. Say thank-you - sincerely and often.
4. Get off pain killers as fast as you can. They distort more than pain and make you feel far more emotional than need be.
5. Get into physical therapy at 4-6 weeks and do the exercises.
6. Let the sun shine on your incisions as much as possible without getting a sunburn.
7. Count your blessings- especially when there are none apparent.
Thank-you for letting me share my experience with you. It is very personal and very non-medical but I hope it was a little helpful.
November 1, 2012 Completion
I had my final surgery on October 2 to remove all remaining hardware (the syndesmosis screw was removed a few months after the initial surgery). Get your hardware removed! My ankle has far more mobility and does not have the same "weathervane" talents it had with the hardware in. Two days recovery time...no kidding! Walking, working and although I know my ankle will never be as it was pre-fracture - it feels darn good! I thought this day would never come!