Wednesday, October 27, was four weeks post-surgery. The night before was the first time I had slept without a cast on my foot. It was more comfortable than before, but sleeping still did not come easy to me. I would wake up two or three times each night and was very tired the next morning.
When I felt cramps I would remove the air cast and try massaging my foot, although this was not too easy because I still did not have feeling on the bottom of my foot and it was still tingling. However, it felt good to be able to remove my foot from the cast now and then.
During the day I tried sitting in different places around the house and would still need to elevate my foot now and then. I took my pain medication in the morning and waited until the afternoon before taking it again, as per my doctor's instructions. The pain was intermittent in between doses. Having my foot up, massaging it, or removing the cast would help. Weight bearing and the exercises I did to improve range of motion were also painful but I continued them. It felt good to be a little more mobile but I knew I still had a long road of recovery ahead.
On Thursday the pain was worse than the day before and I was also exhausted from not being able to sleep the night before. The past few nights I would wake up 3 times from either pain or having to go to the bathroom, but the third time I awoke it was hard to go back to sleep due to the pain. I was beginning to realize how much the pain medication had helped in the previous weeks. The pain I was experiencing now was what I had expected all along, and yet it still wasn't as bad as I thought it would be. The tingling sometimes bothered me more. The next day I was going to begin physical therapy and I was worried about the pain that would bring.
On Friday morning I went to Pro Sports Physical Therapy and I talked with my therapist about my situation. Total ankle replacements are not a common surgery and I wanted to make sure he understood that he couldn't move my ankle around the way he normally might. He understood and assured me that we'd be taking things slow.
He measured my range of motion and put ice on my foot for a while, then I did some stretching exercises and tried putting a little weight on my foot. Aside from the tingling, the experience was not as painful as I had worried it would be. My therapist explained that nerves are slow to come back and it could be as long as a year before they did. He said massaging would not help the tingling and suggested putting ice on my foot at home now and then. I was to continue stretching my foot to improve range of motion and continue weight bearing as tolerable.
When I returned home I was very tired... it had been a busy morning for me. Doing my exercises caused pain but I continued them. Around dinner time the pain was bad since I was weaning myself off the Vicodin and Celebrex. I hadn't taken those since the morning but I was continuing with Aleve or Advil when needed. My foot ached and the spasms were sometimes hard to tolerate. I put ice on my foot for 10 minutes and the coldness seemed to make my ankle hurt even more, but I knew the ice would be good for the swelling. While it had gone down considerably, it still needed to go down some more. I dreaded the day when I wouldn't be taking the Vicodin and Celebrex any more and hoped over-the-counter medication would help.
Sunday morning I had taken the last of the prescription medications. The spasms were still coming now and then but walking around seemed to help. Throughout the day I did my exercises and continued to try some weight bearing. I noticed I was able to stand on both feet, distributing my weight almost evenly, and I also noticed that I was able to stand flat-footed, with no shoes on, with my feet together! I couldn't remember the last time I was able to do that. Prior to the surgery if I stood barefoot I had to have my left foot extended forward because it would not bend. Now it still did not have full range of motion and it was stiff when I stood with it straight but that didn't matter... I was so excited to see the first benefit of having a new ankle.
Sleeping at night had not gotten much better over the past couple of nights, but I noticed when I woke up my foot was not as stiff and painful as before. However, Monday morning was different. I woke up to a very stiff and painful foot and as of that morning I would only be taking Advil or Aleve as needed. Exhausted and not feeling well, I rested for most of the day, keeping my foot elevated. The tingling seemed worse than usual, so much that my foot felt numbly frozen, even though it was under a thick sock. I did some weight bearing exercises and moved my foot around to keep it flexible but it was still painful and stiff.
On Tuesday morning the pain was not as bad but there was still tingling and stiffness. I took an Advil and, since I had taken Celebrex before the surgery to help with arthritis pain, I decided to continue with that for a little while longer. I knew the physical therapy and my home exercises would eventually improve the range of motion in my ankle, and then I could stop taking the Celebrex. Although it was tempting, the Vicodin would no longer be an option as it could become addictive.