An Introduction

I decided to start this blog so I could help people with their decision to have total ankle replacement. Since I hadn't planned on recording any of this I do not have photos to post or exact timeframes for certain things before this year. The main purpose of this blog is to explain the factors leading up to my decision to have total ankle replacement surgery and to document my recovery afterward. I am hoping my experiences will help those of you out there considering having this surgery.

I will be 40 years old this month. I have always been an active person. Years ago I was enjoying hiking, mountain biking, snow-shoeing, rock wall climbing, softball, aerobics, Tae Bo... anything that would keep me healthy and fit.

On June 17, 2003, my life changed. I was playing softball and a baserunner slid into me, breaking my left ankle. I was told it was a trimalleolar fracture, which basically involves three bones in my ankle joint. Pretty bad break. I had open reduction internal fixation (ORIF) surgery, which resulted in a plate and screws being placed into my left fibula and initially three screws into the left ankle itself. After the stitches were removed, a hard cast was put on for about 6 weeks.

After the hard cast was removed one of the screws in my ankle was taken out. This was outpatient surgery and I left the hospital the same day. Physical therapy was not difficult for me. I tolerated it well and was back on my feet, without crutches, by September 2003. My orthopedist, Dr Steven Erlanger, attributed my good recovery to my healthy lifestyle, which had kept my body strong. I continued with my active lifestyle for a few years without any complications. I even started volunteering at a local cat shelter in December 2006 so I could give back to my community.

Then in 2007 I began having discomfort and stiffness; my orthopedist told me osteoarthritis was setting in. I received a cortisone injection that year and it helped tremendously. I was back to doing all the things I loved doing, including going for morning walks around my neighborhood before work each day.

In 2008 I received a couple more cortisone injections and had a brace ordered for my ankle so I could walk longer distances. The brace did not help with the pain but it helped give my ankle the extra support it needed. Things were starting to get a little tougher for me. The cartilage in my left ankle was wearing away quickly. I could no longer go for my morning walks, which was something I really enjoyed doing. I decided to purchase an elliptical machine; the low-impact workout was good for me. I also purchased a Wii Fit and used those games and exercises to help. I was unable to do the "running" portion as it was too much for my ankle. I was still able to mountain bike but anything hard-impact like hiking or walking were no longer options for me to exercise. After doing any sort of exercise I had to rest my foot, elevating it with an ice pack.

Having my foot flat on the ground was too painful; I could no longer walk barefoot. I had to wear shoes with a small heel so I could walk easily. High heels were out of the question, even though I never really wore them to begin with. My shoes had to either be sneakers with a heel lift inside or comfortable wedges, which have a flat sole and a slight heel, no more than 2" for me. I was now wearing my brace whenever I volunteered at the shelter.

My orthopedist prescribed Celebrex, 200mg once per day, and I was able to stay relatively active, including the use the elliptical and Wii Fit, until the middle of 2009. By then any sort of activity was hurting my ankle badly, including things like cleaning the house. I was also unable to carry anything heavy and walk at the same time. The extra weight on my ankle was just too much. The 2.5 hours on my feet every other day at the shelter basically put me out of commission for the rest of the day. The cortisone shots were not lasting as long as they had in the past. I began parking as close as possible to entrances whenever I went to work or ran errands. A cane was sometimes used for extra support. My orthopedist recommended ankle replacement surgery and although I thought about it, I did not take any steps towards it right away. I wasn't sure about having surgery just yet.

I researched foods that were both good and bad for osteoarthritis and started taking supplements such as glucosamine chondroitin and fish oil to help with my painful joint. I tried keeping a journal to keep track of what factors were affecting my ankle, such as weather or food or activities. In September 2009 I decided to sign up for swimming three to four nights a week at my local YMCA. Swimming is a great total body, low-impact exercise! By December I was getting into a groove and becoming stronger.

My ankle was also becoming weaker. I was unable to be on my feet, walking or standing, for more than 20 minutes. Cleaning the house was almost impossible; I would have to do little by little on the weekend and rest in between each chore. There were certain errands I couldn't run simply because there was too much walking involved. Luckily I work in an office and sit for most of the day, but I was unable to complete tasks that required walking to the other side of the office or upstairs to the next floor. My daily activities were becoming severely limited.

It was time to take action. My first step was losing weight. In April 2010 I joined Weight Watchers with the intent of losing 20 lbs. I knew this would significantly reduce the stress on my ankle. I joined an arthritis forum group and read about other people's experience with osteoarthritis, what they were doing for relief and also if anyone else had undergone surgery. I searched for blogs and forums and read up on people's comments about their experiences. I searched online for sites explaining total ankle replacement surgery, what was involved and what the recovery period would be like.

In June 2010 the x-rays showed there was absolutely no cartilage left; I was completely bone on bone. My worst fear was ending up in a wheelchair and my orthopedist told me if I didn't do something about my ankle, that was exactly what was going to happen.

By the time August arrived I was close to reaching my weight loss goal and although my ankle was doing better because of this, I was still very limited in my daily activities and I knew my ankle would not last much longer. My journal showed that food, weather and activities may have had some impact on the pain and discomfort, but the fact of the matter was that my ankle had deteriorated and would not be getting better any time soon. The time had come to seriously consider undergoing total ankle replacement surgery.