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. :)
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!
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!
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.
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!
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!
Wednesday, March 2nd, was twenty-two weeks post-surgery. My ankle was still feeling sore due to the rainy weather, but I was definitely over my sinus infection.
On Thursday I woke up feeling great; the weather was clear and dry and my ankle didn't hurt at all. That day I did some new exercises at physical therapy, working on stabilization. I still couldn't lift my body weight on the ball of my left foot; standing on tip-toe was difficult. I could do it with both feet but not on my left foot alone. My therapist told me this was due to the lack of range of motion in my ankle, and not necessarily due to the lack of strength.
I spent most of the day on my feet Friday, and my ankle felt fine afterward. On Saturday morning I went to the shelter and then to physical therapy in the afternoon. My ankle was sore afterward, but it was nothing I couldn't handle. Before the surgery I would have been off my feet for the rest of the day after going to the shelter.
My therapist told me we might try tapering off with the visits at this point. I was currently a member of the YMCA and could use the gym there a few days a week while cutting down my therapy visits to once or twice a week. There were plenty of machines to use at the gym, such as the treadmill and leg press. I felt as though my therapy had taken me just about as far as it could... my ankle would get stronger and more stable but I would be able to work at it on my own.
Wednesday, February 23rd, was twenty-one weeks post-surgery. That night I pushed myself on the Wii Fit, playing games that required ankle movement and really focusing on using my left ankle rather than relying on my right. I felt pretty sore afterward, but good!
On Thursday I started feeling sick, like another sinus infection was coming on. I didn't go to physical therapy that night nor on Saturday; I went to the doctor instead and began a course of antibiotics.
I went to physical therapy on Monday and took it easy because I wasn't feeling 100%. I started paying attention to the weather because I noticed that when it was clear and dry, my ankle felt fine. When it was wet and cloudy, my ankle hurt. My therapist told me this might always be the case with my ankle, but there as also a chance that it was temporary.
The weather was rainy on Tuesday and my ankle was very sore... I hoped the weather would clear up soon!
Wednesday, February 16th, was twenty weeks post-surgery. By that Friday I had noticed that I hadn't taken any Aleve the entire week, and my ankle was feeling good. The only times I noticed it was sore were days after physical therapy, and when the weather was particularly cold. On those days it was harder for me to push off my foot when walking, but I persisted and felt as though my walking was becoming more smooth, I was taking more strides rather than limping so much.
My energy level seemed to be increasing. I wasn't sure why, but maybe it was because I could see that I was improving. On Saturday I was at the shelter in the morning, then went to physical therapy, and then ran some errands. Before my surgery there was no way I could have had a day like that. The shelter would have put me out of commission for the rest of the day.
I was definitely seeing the benefits from having had the surgery, but I knew there was still work to be done. I began using the trampoline at physical therapy, and it was hard and painful to push off my left foot. I had to concentrate on increasing my ankle strength. Any type of movement that required pushing off my foot or leaning forward onto the ball of my foot was difficult. This was the next obstacle to overcome.
Wednesday, February 9th, was nineteen weeks post-surgery. Physical therapy was still going well and I worked more on pushing off my left foot when walking, as opposed to putting my right foot down and lifting my left foot up to walk. Pushing off my ankle was uncomfortable but I knew the more I did it the stronger it would become. When it came to putting all of my body weight on my left ankle, I just couldn't do it... I definitely needed to increase my strength.
On Monday, February 14th, I stopped using my handicapped parking pass at work and parked a little further away from the building entrance. I probably could have stopped using the pass a few weeks earlier, but the snow and ice on the ground made me nervous and I just wanted to get inside as quickly as possible! With the snow and ice finally melting away I felt more comfortable and knew it would be better for my ankle if I started walking a little further on it.
I also wanted to start paying attention to the weather; it seemed cooler temperatures or low pressure seemed to cause my ankle some discomfort. I felt it was important to keep track of this so I could plan ahead in the days to come, work around the knowledge of whether or not my ankle would be sore that day.
Wednesday, February 2nd, was eighteen weeks post-surgery. I had slowly been getting back into my exercise and physical therapy routine after my illness.
On Thursday my physical therapist noticed that my ankle had more range of motion and my Achilles tendon was not as tight. Maybe my "week off" did some good!
By Monday I was fully back into my routine and working up my strength again. There hadn't been too much change in my ankle strength or discomfort, except that some exercises hurt a little because I hadn't done them in a while. The numbness and tingling still persisted, some days better than others. I knew those sensations would last for a while.
Wednesday, January 26th, was seventeen weeks post-surgery. I was still suffering from bronchitis and couldn't do much. On the bright side, my ankle was feeling better because I wasn't on it all day long. I had to cancel my physical therapy appointments; I just didn't have the strength to go. By Friday I was feeling better, although still not 100%. It seemed like the antibiotics were finally kicking in.
I went back to physical therapy on Monday, January 31st, and took it easy as I was still on the road to recovery.
Wednesday, January 19th, was sixteen weeks post-surgery. The soreness I had been feeling lasted into Thursday, and it seemed my foot was more numb and tingly than usual. At times there were sharp, stabbing pains in the toes, heel and along the bottom. The worst part was not being able to massage the areas because they were numb. The same thing happend if I had an itch; scratching was useless.
My therapist thought I could be having a spasm, he sad this was normal and it was also normal to have set-backs. The weather was also bitterly cold and this could be affecting my muscles.
On Friday I canceled my physical therapy appointment; the soreness was just too much and I didn't want to make it worse. Over the weekend the soreness continued but it seemed to be getting a little better; I tried to stay off my feet as much as possible. I started to wonder if I should be pushing myself... maybe the muscles were getting stiff and needed to be used more.
I started to feel upset about the numbness, tingling and soreness. I worried that this was going to be permanent and that everything I'd gone through was for nothing. Overall the discomfort was still better than what I had experienced before the surgery. I suppose I just wanted to be "normal" again; the recovery was going well but it seemed to be taking so long! I reminded myself that my therapist said setbacks were normal and knew I should contact my doctor if the discomfort persisted.
Over the weekend I became sick and was told by the doctor that I had bronchitis.
Wednesday, January 12th, was fifteen weeks post-surgery. When I went to physical therapy on Thursday I told my therapist that my ankle had felt sore the past couple of days. He felt it could be the weather; we had had a snowstorm and he said when the pressure drops it might affect my ankle. This may or may not be a permanent thing... only time would tell.
This was a little disappointing to me but I had to remind myself that the pain I was feeling now was still so much less than the pain I was experiencing before the surgery. The soreness was tolerable and didn't affect me half as much as the arthritis pain did.
Over the next few days I worked on rolling my left foot completely through each step, trying to push myself forward while walking. It was uncomfortable but tolerable and I knew it would pay off in the long run. I showed my therapist what I was doing on Monday and he said I was doing much better and to keep working on it!
The next day there was rain and I noticed my foot was stiff and sore once again. Working on my walking was difficult and more painful. I didn't do my home exercises either, because of the soreness. I hoped it would pass soon.
Wednesday, January 5th, was fourteen weeks post-surgery. Full-time days at work that week with physical therapy afterward were draining me but my ankle was holding up very well.
My ankle was definitely getting stronger but the pai in my Achilles tendon was very intense when the therapist massaged it! That was the one part of physical therapy that I dreaded... the massage of the tendon. At home I continued my stretching exercises knowing eventually the pain would go away, and I worked on my balance exercises to help get my strength up. The Achilles tendon pain and getting the strength back were two hurdles I definitely couldn't wait to overcome! Each night and each morning I also massaged my scars with cocoa butter to help the healing process; they were healing well but were still painful to the touch.
On Saturday I returned to the shelter after three months of being away... it felt great to be back! Before the surgery I would be at the shelter for 2-2.5 hours in the morning and then my ankle was done for the rest of the day. It would be sore, I would be limping, I was pretty much useless! This day was different; when I returned home my ankle was sore but nothing like the soreness I had experienced before the surgery. That afternoon I was able to run errands and take care of household chores... all without any discomfort.
By Monday I noticed that my Achilles tendon did not hurt as much when I was walking; the extra stretching exercises I was doing were definitely helping. At this point the hardest part of the recovery period was working full-time, going to physical therapy, and attending to all the little details of my every day life. I found myself pretty tired at the end of each day!
Wednesday, December 29th, was thirteen weeks post-surgery. My ankle was feeling good that day... the past couple of days it had been sore, probably due to the weather. Physical therapy was going well and I started using the treadmill, walking backwards, for two minutes. The object was to put more pressure on the toes and ball of the foot, and the exercise was easier for me than I thought it would be.
I hadn't been at the shelter in three months and was anxious to get back. My physical therapist thought I was ready, and although he didn't feel I would need the air cast, he suggested I bring it along just in case. I knew there things I could do that wouldn't require too much lifting on my part, and my son usually volunteered with me so he would be able to help me out.
Over the weekend we drove out to the beach for a little day trip. I did more walking on the beach than I had in a long time, and when we came home I cleaned the house a little, and my ankle was feeling just fine! I was so happy... before the surgery I wouldn't have been able to walk as far on the beach as I did that day, and even after the little bit of walking I could do my ankle would have been done for the rest of the day. It was sore but tolerable, and the soreness was expected. The best thing to do would be to ice it up and elevate it. I was feeling good and knew that I was well on my way to getting my life back.
On Monday I returned to work full-time and then went to physical therapy afterward. Needless to say, I was pretty exhausted that evening!
