Saturday, October 26, 2013

Three Years Later...

Every year I follow up with my surgeon to make sure everything is fine with my "new" ankle. On Tuesday, October 15th, I had my routine x-rays done and was told that it appears the plastic is beginning to wear and I have a bone spur. Looking at the x-rays myself I could see a difference in my ankle from last year's x-ray. The plastic part is lower and the bone spur is in the front of my ankle. That spot has been tender for a little while now but I thought that was just normal tenderness from standing or walking too long. Overall the bone spur hasn't seemed to affect me and I have been trying not to think about it. Of course after my visit that day my ankle felt sore for a few days but that was probably because I was thinking about what was going on.

My surgeon assured me the hardware itself is fine, and I could see it in the x-rays. It is simply the plastic that has shifted or worn down a little. He said the wear and tear seems to be happening sooner than he expected but he knows that I am an active person. I still enjoy hiking, walking in my neighborhood, using my elliptical, volunteering at the cat shelter, swimming, and cycling. I have a mini-trampoline that I had been using to "jog" in my den, but my surgeon suggested I stop using it because it may be putting too much stress on my ankle.

I have a follow-up appointment in six months so my surgeon can gauge what is happening with the plastic and then we will go from there. He said it is possible that we may have to change the plastic and the surgery and recovery are not as difficult as the initial surgery, but of course I will need physical therapy again. He advised me to go about my daily life as usual; not to treat my ankle any differently (except for keeping away from any kind of impact) and not to worry.

I asked my surgeon if I would eventually have to have the ankle fused. He considers that a last resort and said technology is changing all the time. New replacements are always coming out and we may find something better. He also said I may become tired of having surgeries to replace the plastic and don't want to "have a zipper" in my ankle and I may decide on the fusion. He advised me to wait it out another six months and make my decision then.

By nature I am a worrier but I am trying my best to stay positive and remember what it was like before my surgery. The pain and the difficulty in doing everyday things. I am still so much better off than I was over three years ago. Being an active person is who I am and I cannot sit still, although I will be careful not to do anything that will jeopardize my implant.

I will post updates over the next few months, if there are any changes, and will definitely post up on my progress at my six-month follow-up. Thanks for reading!

Thursday, October 6, 2011

One Year Anniversary!

Well... here it is, my one year anniversary. Had my follow-up a couple of days ago and my surgeon says everything looks great. The implant has fused well to my bone and the bone appears to have gotten stronger. The scar is healing well and although it is still visible, it is lighter. My range of motion is good.

My left foot is still somewhat numb and tingly on the bottom but the sensation is definitely less than it was before. I still wear sneakers for extra cushion; heels are no longer an option. My left ankle and calf muscles are still weaker than my right and standing for long periods of time are uncomfortable, but overall I am not experiencing any limitations. There are times my ankle does feel sore, but the discomfort seems to be muscular and not the implant itself. Now it's just a matter of strengthening.

Life has been very good. I have been so active, going places and doing things I would never have been able to do before this surgery. This past summer we went on a vacation that required lots of walking. I've done some light hiking. I'm able to clean my entire house in one afternoon, rather than breaking it up into two afternoons. I can carry things up and down the stairs with ease. I'm able to be on my feet for two and a half hours at the animal shelter in the morning, and then run errands later that same day. I've joined a gym, swim laps in the pool and ride my bike (on pavement, of course) for exercise.

To anyone who is considering having this surgery done, I say go for it! Your ankle will never be the same again... but when you fractured it you knew that, didn't you? You may have some limitations. There may be things you will no longer be able or permitted to do. I was a passionate mountain biker and I have had to give that up. But in return there are many, many other things I can do now that I couldn't do before. There is no more pain or discomfort. There are no more excuses.

When considering this surgery, another important factor to remember is having emotional and physical support. This is a major surgery and the recovery period will be different for everyone, but it is crucial to have a good team behind you. Someone to visit you in the hospital. Someone to bring you home. Someone to help you shower. Someone to help you up and down the stairs. Someone to bring you things you may not be able to grab yourself. Someone to hold your hand when the pain comes and remind you that you made the right decision.

If you are also considering ways to stay fit and strengthen your ankle again after the surgery and after your physical therapy, remember to check with your surgeon and/or physical therapist about any limitations you may have. No matter what family or friends or coworkers may tell you, remember that you want this implant to last a long time. There are plenty of activities you can do without putting any additional stress or weight on your ankle, and that don't involve impact to your ankle. Be smart and trust your instincts.

Thank you to my family, who were there for me when I needed them most. Thank you to my friends, who were there to cheer me on. Thank you all for reading this blog; I hope I have been of some help to you. Most of all, thank you to Dr. Ayal Segal and Pro Sports Physical Therapy for giving me my life back. :)

Friday, June 10, 2011

Week Thirty-Six

On Thursday, April 6th, I had my last physical therapy appointment. It was bittersweet because I knew I was strong and could continue my exercises on my own, but I was going to miss the people at the facility. My therapist wanted me to come back in a month so he could see how I'm doing and make sure my strength was holding up.

In the following weeks  I rode my bike and went swimming for the first time in six months. My ankle held up well for both activities. I began going to the gym to keep up my strength and one day, after doing seated calf raises, noticed that my left calf was very sore for a few days. Most likely I pushed myself too hard and pulled the muscle. I stopped doing my exercises for a few days and then the calf felt fine. From then on I knew that I had to take things slow and easy where my left ankle and calf were concerned!

Wednesday, June 8th, was thirty-six weeks post-surgery. The past few months have been great... the best I've had in years. I have been going to the gym, swimming, and using my elliptical at home on a regular basis. Every morning I stretch my leg muscles to keep things limber. For the most part there has not been any soreness.

My activities and energy level have increased a great deal but I still need to pace myself, because if I walk too much or spend too much time on my feet my ankle does get sore for a day or so. Still... the pain is nowhere near what it was pre-surgery.

The tingling sensation is still present on the bottom of my foot and in my toes, and I do continue to get small spasms but they don't seem as painful as they were before. The tingling is (very) slowly but surely subsiding.

One of the things I have noticed is the inability to wear shoes with heels. Low wedges work fine for me but they need to be cushioned... hard, solid heels are not comfortable to walk in. Luckily I was never a high-heeled shoe girl to begin with!

Another thing I need to be mindful of is how weak my left calf is, from atrophy and all the years of not using it properly due to the pain I was in. I have gotten to the point that I can stand on my tip toes but only if I'm holding on to something and only if I have my right foot down... and even then most of my weight is on my right foot! I am unable to lift my body by tip-toeing on my left foot alone. I'm not sure if I ever will be able to do that again, but I'm going to continue working on developing and strengthening that calf muscle.

Over the past few months I've noticed that I can carry a little more weight. Before, I would have to be very careful carrying heavy objects, because my ankle couldn't handle the extra weight; either I was in pain or I just couldn't manage getting around. Now I can carry things like laundry baskets and grocery bags without a problem... it's wonderful! I'm still careful going down stairs with a laundry basket, only because I'm not sure of keeping my balance just yet. My ankle is strong but I don't to take any chances. So I still go down the stairs backwards if I'm carrying a laundry basket or anything like that.

Hopefully you will all continue reading... I've been much more active and don't get on the computer much to post... I'm sure those of you who have been or are going through what I went through can understand! I'm getting my life, freedom, and independence back... it's wonderful!

Tuesday, April 12, 2011

Week Twenty-Six

Wednesday, March 30th, was twenty-six weeks post-surgery. That day my ankle felt fine and that evening I used the elliptical for 20 minutes without any pain afterward. I still iced my ankle though, as recommended by my physical therapist. I was so happy to be able to use my elliptical and not have any pain or discomfort!

On Thursday, my therapist told me to come in just once the following week and then we'd see what we'd do after that. I would go to the gym that Saturday and then again on Monday to supplement the physical therapy visits. I knew if I kept up with my strength-training and stretching that I would be able to get my ankle stronger and more flexible over time. I started a routine of stretching each morning and stretching each evening, knowing that little by little I would be able to hold the stretches longer.

On Saturday, I volunteered at the animal shelter and then went to the gym. My ankle was sore but held up great! I put ice on it after both outings.

On Sunday, I ran several errands for most of the day and again, my ankle held up just fine. I iced and elevated it after returning home. There were times I wished I had no pain at all and it became a little discouraging, but I had to remind myself that my ankle was still healing and even the discomfort I was feeling now was 100 times better than the pain I was feeling before the surgery. The discomfort was something I could live with and I knew it would subside as my ankle became stronger and healed.

One thing I noticed that I had started to gain a little weight; this was probably due to not eating the right things and not exercising enough. That definitely had to change! I planned to change my diet for the better and use my elliptical for 20-30 minutes in between physical therapy and gym visits. Also, once my physical therapy was over I decided I would supplement that third visit with swimming. I needed to make sure I didn't gain weight and put too much stress on my new ankle!

Monday, April 4, 2011

Week Twenty-Five

Wednesday, March 23rd, was twenty-five weeks post-surgery. I was still feeling pretty good, until I went to physical therapy that Friday and had my tendon stetched by the therapist! That was one thing I hadn't been doing consistently... although my arthritis was gone I still needed to stretch and keep my muscles flexible.

The next day my ankle was still sore but I finally went to the gym. Using the equipment felt great... after "running" on the elliptical for 10 minutes, I used the leg-strengthening machines. Felt wonderful! I tried the treadmill but didn't like it; I think I may have been trying to walk to fast and it seemed like my ankle was very sore afterward. At physical therapy I walk backwards on the treadmill but I couldn't bring myself to do it at the gym. I felt like everyone would be looking at me! When I saw my therapist that following Tuesday, I was told that walking heel-to-toe does put more impact on my ankle and since I may have been walking fast that could explain the discomfort.

I also saw my orthopedic surgeon for a follow-up that Tuesday, and he said everything was healing nicely and I didn't have to see him again for another six months. He also gave me the green light to go hiking and biking (on pavement only, of course). With hiking he told me to make sure I wore boots that covered my ankle to provide additional support. I knew this wouldn't be a problem since I already had hiking boots, and walking sticks too. He reminded me to start off with easy terrain and when I started to feel tired I should turn around and head back. With biking he told me to be careful not to fall on my left side. I asked him about my pedals; my biking shoes clipped into them and I had to twist my ankle to get my foot off the pedal. He said that was fine, my ankle would be able to tolerate it. The news that I could start enjoying the outdoors more was so exciting to me! I couldn't wait to get out there.

Another thing my surgeon warned me about was being pre-medicated before any invasive procedures, which meant taking antibiotics before-hand. I had tried to get my teeth cleaned a few weeks earlier and the dentist would not do it unless he had clearance from my surgeon. Although it was a simple procedure, there was a possibility that I could bleed and then bacteria could get into my blood stream and infect my ankle joint. So my surgeon gave me a prescription  for antibiotics and I planned to make another appointment for my cleaning. I would strongly suggest anyone planning to have joint replacement surgery or any other type of surgery check with their doctor about needing to be pre-medicated before any invasive procedures done after the surgery.

On Thursday, my physical therapist told me my visits were winding down. He was happy about my surgeon's report and didn't think there was much more my therapy visits could do for me. I was feeling the same, like the therapy was starting to plateau. He told me to come in twice the following week and go to the gym again on Saturday to supplement the third therapy visit, and then the following week after that we would see what we'd do next.

Week Twenty-Four

Wednesday, March 16th, was twenty-four weeks post-surgery. The dizziness from my sinus infection lingered but subsided little by little each day. By Friday it was just about gone.

Unfortunately the dizziness kept me from going to the gym at the YMCA but I knew I'd get there once I felt up to it. In the meantime I tried to continue my home exercises but that was not always easy since I was busy with many things. I figured the more I walked around and kept mobile, the better the strength-training for my ankle. I knew it would never be 100% again, but knowing I could walk around pain-free was worth giving up a little range-of-motion. I also kept up with the elliptical and the Wii Fit to help maintain my strenth.

On Sunday we went out to a nature preserve and I was on my feet walking the grounds for a few hours... about four total. There were times I needed to sit and rest my ankle but otherwise I did very well. At one point my husband and son walked on the beach but I stayed behind and rested on a bench; I knew my ankle could handle the uneven terrain of the sand but I also knew that walking in the sand would tire my ankle out and I wanted to continue walking and enjoy the day without pain. When I got home I did ice my ankle but overall it felt great!

Friday, March 18, 2011

Week Twenty-three

Wednesday, March 9th, was twenty-three weeks post surgery. I noticed that sometimes on days when the weather was damp or rainy, my ankle was not sore... and then on other days it was. I was beginning to think there really was no rhyme nor reason to what made my ankle sore; it was probably something that I was just going to have to deal with. My therapist had told me that the soreness could go either way... it would either remain for the rest of my life, or my ankle would heal and the soreness would subside.

Another thing I noticed was how much more active I was becoming. I was on my feet more, running errands and doing household chores without thinking too much about it. Things I couldn't do before, like work at the shelter in the morning and then run errands in the afternoon, were becoming easier. I could carry more weight when walking, but still had to be careful with anything too heavy, especially when going up or down stairs.

My increasing energy and activity were making it difficult to keep up with my blog, and unfortunately I felt that my blog was becoming stale... there weren't too many more obstacles to jump over and report about. On the bright side, I was able to write about how much the quality of my life had improved. That in itself was worth sharing, and I knew it would give others out there more motivation and comfort in making their decision to have this surgery. It always felt great to read comments posted and know I was helping someone get their life back.

Thank you all for reading... and forgive me if I am not as diligent in posting... remember that in my book, no news is good news. I will keep you all posted on my progress and hope you benefit from my experiences!