Broken Ankle Pt. 3: Week 5-12 Recovery

Sunday, March 15, 2015

Hi everyone! It's been a long, challenging few months trying to adapt to a broken ankle, but as you can see I'm still alive lol and I do think the worst is behind us. As of today, I can currently walk but with a limp which I have to get rid of by trying to make sure my right foot (the one the broken ankle is supporting when I walk) takes the same time to land as my left foot. I tend to land faster on my right foot which is essentially why I'm limping. I just can't seem to balance myself because my muscles are weak, but it's a work in progress! It feels like I'm hitting a plateau really.

Warning: Many disgusting photos of my leg ahead :P

1. Walking boot
The doctor I'm seeing recommends I don't use a walking boot because "he doesn't believe in using the boot". Well while I understand that maybe he's going for a less financially burdening approach, I was worried it might impede with my healing process and isn't making me put excess pressure when I bear weight without a boot. But so far, I'm dong okay without the boot.

2. Slip N' Slide FALL
85% of the times I slipped it was because of my slipper. It lived up to its name because it literally became a slipper for me, always making me slip and fall, giving me more pain as if I wasn't already in pain. Getting rid of that wretched footwear (for now)!!! Don't know why I didn't do that earlier, I gave it the benefit of the doubt. It brought nothing but pain. I found a better alternative: I converted to wearing sport shoes and hadn't slipped since then. Planning to invest in some good quality footwear for once like Birkenstock. Having flat feet doesn't help.

3. Scarring/Dry skin
My skin was extremely dry from being in a splint for so long. But after a while my skin started to peel and the dryness is gone :)

Somehow there is a dark brown blotch with a pink centre directly at my spinal anesthesia injection site from my last ORIF surgery. It may be a hyperpigmented scar. I only found out about it on week 6 post surgery because how often do we look at our backs in the mirror. Maybe it was because of the abrasiveness right after the injection, but I was not expecting a scar. It's not giving me any pain or discomfort at all, and it's... just there. And the fact that it's there bothers me!

My scars from the surgery on my ankle are still healing. I'm afraid they may turn to keloid scars because the scars seem to be 'raised' and not flat :( I have one obvious keloid scar on my chest so I guess I'm more susceptible to more keloid scars. Let's hope not!

Below is a comparison of my foot from week 5 to 10. The awesome process of healing <3


4. Muscle atrophy
My calf muscles are still atrophied! Thinking of the muscles and fitness I tried to gain during 2014 all gone is kinda sad.

Atrophied left leg compared to normal right leg

5. Syndesmotic screw removal
Took out my syndesmotic screw on week 6. This time for surgery, I opted for general anaesthesia, where they put me to sleep. I tried epidural so now I wanted to try general anaesthesia. Definitely less painful of course, only the part where they put in the IV line hurt like a mother.

It was such an interesting experience. The first stage was induction, and they put in some drug in my IV line, and 5 seconds later I felt light-headed. I was surprised at how fast the drug traveled through my blood stream. It was a very psychedelic moment lol. The room felt like it was rotating. And then they put on the breathing mask let me breathe in the drugged air and I couldn't remember when or how I fell asleep. Not really even a gradual sleepiness. Just bang, I was asleep. There's just something about anesthesia induced sleep that feels really good. I think it's the instantness of rest. Nowadays sleep doesn't come easy for me. And to just fall asleep and slip away from consciousness without pain like that felt relieving and somewhat relaxing. I'm weird that way :/ I woke up outside the O.R, feeling tired and a tiny bit nauseous. Once again, thank God I didn't suffer from intense nausea or a sore throat.

I read online, and usually people take their syndesmotic screws out like at least on week 8 to ensure everything is joined and healed. Apparently taking it out on week 6 is pretty early? Oh well it's out already anyway.

6. Learning how to walk/Physiotherapy
My range of motion (ROM) was pretty limited in the beginning. Apparently the first time my physiotherapist (PT) saw me she said I could only move my ankle to a 90 degree angle (neutral), and that was it. I couldn't move my ankle up and down (dorsi/plantar-flexion). I was gutted, but I knew this was the beginning of my healing process and there will be improvement if I worked hard. Right now it feels as if it's not improving at all and I'm worried it may be due to too much scar tissue (worst case scenario - I'd have to go for another operation to remove the scar tissue).

Starting to take your first steps (with crutches of course) after not bearing weight on your leg for 6 weeks will be pretty terrifying. I'm always afraid of pain, and I always think that I might break my already-fragile ankle again. So far, after 6 physiotherapy sessions, I'm able to walk without crutches (with a limp)! It still gives me a dull ache or feel like my tendon is stretching whenever I bear weight, which I hope will go away. I needed my physiotherapist to teach me how to walk properly, as if I forgot how to walk! I was swaying too much, my hips were leaning towards the right too much, my knees were too straight... all without me even realizing it after not walking normally for about 2 months. And so the day after I was given full weight bearing exercises, my muscles everywhere ached! My hip, my butt, even my good leg hurt (which I assume is normal due to my lack of activity). Almost like 1 step forward, 2 steps back. But it's all the process of recovery.

Also, the area where my Achilles tendon always hurts and is always very sore. My PT said I experienced shortening in my tendon from being in a splint on my left leg for so long. I also have scar adhesion at the stitches site, where my tissues are stuck to the bone, and is not letting me do ankle inversion to its full potential which sucks and impedes my rehab process. My PT gives me these extremely painful massages along my left calf muscles to help it not be so stiff. She makes me rotate my ankle at the same time! I shudder at the thought of the pain. It leaves my calf feeling very bruised for the whole week. It's like she finds pleasure in my pain.

My ankle was initially swelling pretty badly. But after around week 9, after listening to my PT's advice to apply ice (which I'm not sure helped or not), my swelling has significantly gone down. It used to swell up a lot after half a day of putting my leg down, but right now it doesn't swell as much (still does, but not as badly as before). Not sure if it's because I'm starting to bear weight or because of the ice. Either way, I'm glad the swelling went down because it was so troublesome when I had to go out or go for classes and worry about how badly my leg will swell.

The worst of my swelling during the early weeks of my recovery. GAH CANKLES!
Swollen foot as of today! Still swollen but not too horribly bad. At least I can see my veins now!
Doing dorsi, plantar and inversion flexion exercises at home with a theraband helps. I credit my recovery to my PTs! Because of them, I am able to walk again. They're awesome :)

1 of the 4 ankle exercises I usually do
My PT gives my ankle musculoskeletal ultrasounds before I start my exercises as well, known to vibrate the ankle tissues and scar tissue.

7. Itching
Oh man. This is the worst. Of course I was expecting a little itch and there after removing my splint which had been on for 6 weeks, with all my dirt and dead/dry skin accumulated in that small space. But I did not expect the itching to be THIS INTENSE. It is SO itchy. And worst thing is it's not only on my left leg. It's on my right leg as well. And on week 9 of my recovery, my arms are starting to itch as well. I've had keratosis pilaris for as long as I can remember, and usually doesn't itch that much. But now it's itching up a storm. I hate this! I feel so frustrated all the time because it's itchy and the more I scratch it, the more raw my skin becomes and it gets so ugly. I feel like killing someone.

During the early recovery process I've had petechiae (flat red dots) on my leg too (which is normal because my doctor didn't make an issue out of it).

Ehmagerd my hairy petechiae-filled leg.

Post week 10, the itching is going down. Still not sure if it's allergy to antibiotics or whatever that's toxic in my body, but I'm glad it looks like it's not here to stay because it has overstayed its welcome. One fine day in week 11, the itching came back with a vengeance when I went out for lunch. The funny thing was I didn't even eat anything for breakfast. So I think that indicates that the allergy is not due to my food. Could be the heat, or stress? I don't know. I tried everything from H-Cort/Egoderm ointment to oral antihistamines but these are all short-term solutions. The itch comes back unpredictably from time to time which sucks because I could be in class one day and feel super itchy. Also something I need to consult with my doctor.

8. Laziness
I have become extremely lazy. I could take the extra effort to walk to whatever I need to get or do, but after 2 months of not being able to do that, my body doesn't want to do it anymore. I think one of the best things about breaking your ankle is not having to do chores (look at the bright side, right?). I didn't have to do anything actually. But now that I'm healing and I will soon have the ability to do those things again, I don't want to lol. As if I wasn't lazy enough before I broke my ankle! This is laziness at its best.

9. Adhesions
Yup I have tissue adhesion, where the 2 scars on the side of my ankles are stuck to my bone :/ I'm told to massage the scars whenever I can to tear it away from the bone.

Other than the whole broken ankle tragedy, now that it's slightly less inconvenient for me to do things, I've joined the Edgewiz investment simulation competition and the Maybank Go Ahead challenge! Not that I'm expecting to win them because I know nothing about investments or banking, but it would be a good experience for sure. Trying to be busy so I can distract and get my mind off things I shouldn't think so much about.

Also, the plan to go to the US in May/June is formulating! Tickets are bought, and rough itinerary is set. Here's to hoping my ankle doesn't try to be a party pooper for me during the trip :/

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