On healing: 7 weeks out

Today is (finally) Friday.

I had my first physical therapy visit a week ago Wednesday, my second yesterday, and I have  my third today. When I saw the doctor last (May 2), I was one day short of 5 weeks past surgery date. He wanted me done with the crutches by May 9, and out of the walking boot by May 23. I would be able to drive shortly after May 23. At that point I was still relying on the crutches completely, as I was being a good girl and following directions.

Well, that information set me free. I have been working from home since February 13, and the last time I drove was February 12. I had had enough. By May 4 I was finished with the crutches, and I haven’t used the walking boot since May 11. I will be practicing driving Saturday (in an empty parking lot), to make sure that my ankle will tolerate it.

I have been seeing the same physical therapist for the past 6 years (not just the same practice, but also the same therapist – he knows my joints quite well by now), and today I will be starting at a new practice. Because I have not been able to drive, my awesome husband has been chauffeuring me around for the past 3 months. To be honest, we’re both tired of it. However, it has to be done. Anyway. The new PT location is a mere 15 minutes away, whereas the old PT location is about an hour away, next to my office. It was perfect when I would go to PT then go directly to work – it cut down on the commute time significantly. But since I’m working out of the house (for another couple weeks), I can’t lose half of a day due to commuting and PT. It’s not quite convenient.

I’m nervous about seeing a new physical therapist, because Dave – the old one – knows me so well, and we have a good friendship as well. We talk books, we talk munchkin and his kids, we talk life. He gets it. He knows me. How will it be with this next person? Will we end up with a good camaraderie, or will I simply go to physical therapy, do my exercises, report on how I’m feeling, and go home? I spend so much time in physical therapy – in the past 6 years, the longest I went NOT in physical therapy was from February (or was it March?) 2011 to now. I spent 6 months straight at one point going to PT at least once a week. It’s just what happens when I so easily injure myself (I’m working on that).

I spent 20 minutes by myself with munchkin Monday night (while he was awake) – the first time I had done that in 2 months – followed by a couple hours later on that same evening (while he was asleep). It was nice to be able to have the ability to take care of munchkin on my own, and to know that I was trusted enough to do it.

***Fast forward 3.5 hours***

I had PT this morning with a new therapist, Justin. Things were very different from the last place. Old PT is one big room with lots of tables, and nothing is quiet. New PT is lots of little rooms for consults, and then one big room for exercises. At first I thought  – Hey! this isn’t normal. It’s weird! – but then I realized I preferred it. I don’t need everyone knowing my business. There was one other huge difference. Whenever I went to old PT, I made sure to bring a book because I was often on my own for a bit icing or with heat. For an hour appointment, I would really only have Dave to myself for about 15 minutes, and it was definitely not 15 minutes straight through. If I needed to ask a question, I had to either wait until he wasn’t with a different patient, or had to interrupt. I don’t know why they book every 20-30 minutes if appointments last 60. With new guy – Justin – I had him to myself. He worked with me, and I had his full attention the entire time. It was a great change. Justin also focused on things that are going to get me back to where I need to be more quickly, and better – I know all physical therapists are different, but it seemed like new PT had a better handle on what I need to recover to the best of my ability.

So here I am, 7 weeks out from surgery, walking in sneakers, and really in a much better place than I ever anticipated. I’m happy, healthy, and on the right track to being 100% healed.

What have you done better than you ever expected you could?

On healing – 2 weeks plus 2 days

Just over two weeks out, and a lot has changed since last Wednesday. I saw the doc first thing Thursday morning, and he (at first) didn’t even realize that there was any reason for me to be in other than that my cast was coming off; he thought it was my normal appointment. Apparently everything looked good? Once I mentioned that I was in because of the discoloration and issues I was having with the hot toes and funky colored phalanges, he looked at how long it had been since surgery and recanted a few statements; I was no longer allowed to move the foot/ankle like he had originally said (need to wait one more week) and I am not yet allowed to  put some weight on the foot (again, need to wait until next weekend).  However, both things happening this coming week are significantly sooner than I thought they would be.

The cast came off, and I’m in a walking boot – because everything looks so good, he skipped the splint and went right to the boot.

Walking boot

Walking boot

This boot is significantly larger than the other one I had been wearing before surgery. It goes up a lot higher on my leg, and is a lot more sturdy. I definitely feel like I’ll have an easier time with this one than the other one. I have to sleep with this on for a while, so it’s awkward and frustrating, but what can you do. It’s better than nothing, I guess. Better than going backwards. Better than the infection I thought I had.

The discoloration and warmth in my toes is due to the fact that I have swelling in my ankle, and when I stand up, the blood pools in my toes, and due to the extra fluid from the swelling, has a more difficult time working its way back up my leg. It makes sense. I don’t know why I didn’t think of it myself (seriously, not being sarcastic at all).

My ankle has been bothering me more frequently lately than originally anticipated, and I have been relying on the meds more than I thought I would still be. I’ve been trying to use Aleve more than the painkillers, but between the increased pain (because of the cast coming off) and the muscle spasms that have begun to happen more frequently, the pain is still pretty bad. I hate taking the painkillers and the meds for the spasms because they knock me on my ass – within 20 minutes of taking the painkillers (with food or without) my short-term memory is shot and I can’t form much of a cohesive sentence. It lasts for a good 2 hours or so. I’m currently scheduled to return to work on Wednesday (working from home for another 6-8 weeks), but I don’t know that I will be able to. I sure as hell can’t work on pain meds. My original plan was to start back April 22, giving me another full week, but it’s not that easy – I’m at the mercy of the short-term disability company, and so far, they want me back on Wednesday. I’ll be speaking with them either Monday or Tuesday to plead my case, but I’ll be getting the doctor’s “return-to-work” date before that. I need my doc to approve when I can return before I am allowed to start working again, and I need it in writing. We shall see.

Friday everything pretty much came to a head. I realized that it has been a full two months since I left the house of my own accord – since I drove last – since I worked in the office. I feel like I have absolutely zero independence. I rely on my husband for everything – preparing my food, making sure I don’t fall while bathing, taking care of munchkin. And I lost it. I cried for a good hour, just trying to get my frustrations out. I knew this would happen, because I’m incredibly independent; I always have been. I’m ready to be able to walk again, to drive again, to leave the house and grab a gallon of milk if we need one. I want to drop munchkin off at daycare, I want to get back to my normal, everyday routine. I miss it. I miss not needing to wake my husband up in the middle of the night if munchkin needs something or if I need to pee – shouldn’t I be able to do that on my own? But I can’t get to my crutches without falling out of bed. So I need him to get them for me, so I don’t hurt myself again. As thankful as I am to have the help, I feel guilty – there’s so much more that he needs to do because of my injury, because of my joints not working correctly. I need to get over this feeling of guilt. I have been apologizing too much.

When I was very pregnant with my son, my mother kept telling me one thing over and over again, and I think that it pretty much (in a roundabout way) applies here too, so here it is (paraphrased): every day/hour/moment that passes in my recovery is another day/hour/moment closer to being back where I want to be. It’s one less moment I have to get through, it’s one less moment I need to worry about. Once it’s done, it’s done.

Two weeks and two days down. At this point, I don’t know how much time is left until I’m back in the old routine, but at this point, in the long run, it’s two weeks and two days less than the total. I’m headed in the right direction. I can do this. I have to do this. I’ll get through it.

On healing – 2 weeks minus 2 days

I’m almost two weeks out from surgery. Things have been going great. I have my cast. I have the medications I need for pain, for muscle spasms, and for nausea. I have been following instructions: staying off of it completely, and exclusively relying on the crutches to get me around. I have been elevating whenever I can. I do not get my cast wet. I do not overdo it.

I noticed a few days ago that the one of my toes is completely numb. I assume it’s from the incision and needing to cut through a nerve. It’s a weird feeling, but nothing I didn’t expect. The feeling could come back, or it may not. It may partially return; I have no idea. I just need to wait and see.

I have noticed a few other things lately that I have been brushing off as “normal” and as me overreacting. This afternoon, however, I noticed something that caused me to turn around, sit back down on the couch, and call the doctor: two of my toes were extremely red and hot, and I was having burning in the area of two of my incisions and a deep throbbing in my ankle joint. Because I didn’t call until 4:15pm and the office closes at 4:30 (I have impeccable timing), I have an appointment for 8:45 tomorrow morning. I have a feeling they’ll be a) removing my sutures and b) replacing my cast.

After the last time I had surgery when I had an infection, I’m beyond terrified that it will happen again. I’m trying to be as positive as I can be, but I seriously don’t know what is going on. I don’t think it’s supposed to feel like it does. I guess we’ll see tomorrow.

One thing I never mentioned last week when I posted were the difficulties I have been having being as hands-off as I have needed to be. Because I am unable to do most things that require me to walk or to be on my feet at all, I have not been able to help out around the house as much as I would like, and I am unable to care for munchkin as I have done since he was born. It’s incredibly difficult to not bawl my eyes out every single time something needs to be done that I can’t do watch my husband do all the major things around the house and not feel incredibly useless as if I’m leaving all the crap jobs work for him to do. I feel horrible, and I keep apologizing, and I think it’s driving him nuts; I’ve stopped as much as I can, until I lose my shit again and start sobbing and then I apologize again and again until I feel incredibly badly about something that has gone wrong or something I used to exclusively do. It’s tough. I am having a really hard time being so hands-off. I keep losing my shit, and it drives me crazy. Additionally, I can’t drive – which means that every single time that I need to go to the doctor, my husband has to bring me. And munchkin has been sick a lot the last few weeks – the week I had surgery (surgery was a Friday), he was out sick from school Tuesday, Wednesday, and Thursday, and then Friday he was with my parents. Last week he was sent home by 9am on Friday. This week he was sent home sick today. Because he has been out, my husband has also had to be out because I can’t watch munchkin myself. I can’t pick him up out of his crib when I need to, I can’t put him into his highchair when I need to, I can’t cook him food, I can’t really do all too much for him. So for every day that munchkin is not in school, we have to pay as if he is there – but my husband also can’t work. It’s the most annoying thing in the world, right now. It’s incredibly frustrating.

So this healing thing is obnoxious and frustrating and nowhere near a barrel of laughs; I’m just waiting for the next can of worms to open up. Not impressed, and we’ll see. Maybe that other shoe won’t drop after all. I just need to take it one day at a time. One.Day.at.a.Time.

On healing – one week out

***If you’re grossed out by incisions, don’t look at the photos. Or just skip this post. They’re not bad, but just a heads up.***

This past Friday, I had surgery on my ankle.

Surgery was a little different than we had expected – some things that were expected to be done were not done, some other things that were not expected to be done were done. I have an extra scar: two on the outside of my ankle, one on the inside of my ankle. More than expected.

But let me back up.

Friday morning we had to be at the hospital by 6:15. AM. Yes, I asked to clarify that when they told me the arrival time. Thursday night we had met my mother halfway between their house and ours – and she took munchkin back to their house, to watch him for the first weekend after surgery. It was a huge weight off of our shoulders. Friday we were up and out early – up at 445, out by 530. We’re not morning people, so it was impressive. We got to the hospital, and they said I was up first. They brought me back to the holding room, where I changed into the fashionable johnny and waited for what was next. They filled me in on the details – they were going to put in an IV for general anesthesia, but in addition to that, they were going to put in a nerve block – numb me below the knee along the nerve line. In addition to extra comfort immediately following surgery, the catheter for the nerve block would stay in for a couple days, giving me up to two to three days more of a numb leg. I was all for it.

I woke up after surgery, still a bit out of it, to find my leg looking like this:

My leg, post surgery, with catheter above the knee.

My leg, post surgery, with catheter above the knee.

I had no idea what had happened. I had no idea what was going on. I was very out of it. After a couple hours (I think? I was out of it!) of coming out of the anesthesia and getting used to the bulk of my leg – leg wrapped in gauze, topped with a splint, topped with more gauze, only to be topped with an ace wrap – we were released to go back home. In that couple hours, I have little memory of any conversations that I had or anything I was told. All I knew was that the parts of my ankle that needed to be repaired were in fact fixed, and there were no issues during surgery. That’s all that I needed to know.

One thing that I remember clearly is sticking with me, as it refers back to my previous concerns about this fixing it, but only temporarily – by fixing the extra thing that was found when the doctor opened up my ankle, he has reduced the chances of this happening again. And from what he said, the chances of it happening again were reduced significantly. It’s a huge sigh of relief there. Now I just have to make sure that it holds true.

After a weekend of recuperating, taking my painkillers every 4.5-5 hours, sleeping, and watching movies, my sister (the youngest of the four of us) and munchkin came home. I was so happy to see him. I got in a couple quick snuggles and he went to bed. Shortly after, sister C and I went to sleep as well. Monday munchkin went to school and J went to work; sister C and I watched movies (a really bad one that we only made it 20 minutes of the way through, and then two good ones), chatted, and just hung out. It was really relaxing, and was great to hang out with her. We don’t do it often enough.

Tuesday morning I had my followup with the doctor, and they had told me I would be getting a hard cast, though I had no idea if the difference in surgeries would be changing things, changing the plan. We went in, and they took off the wrap and the gauze, and I got my first good look at the incisions and the state of my ankle. I was excited to see it. A little swelling, which was to be expected – a lot of orange, from the iodine/betadine/whatever they used to keep my leg/ankle sterile – and three incisions, instead of just two.

Where they cleaned out the junk - arthroscopic entry.

Where they cleaned out the junk – arthroscopic entry.

Not too bad, but you can see I don’t have much of an ankle, due to the swelling.

The main incisions. Where everything else happened.

The main incisions. Where everything else happened.

They fixed the tendons and removed part of the muscle, which was causing most of the issues.

An overview - the yellow is antibiotic strips. Note the lack of an ankle.

An overview – the yellow is antibiotic strips. Note the lack of an ankle.

After the surprise at realizing I was only 4 days out from surgery because of how good my ankle looks, they stated that it’s obvious I’m staying off of my foot (duh) and following the doc’s orders to elevate (also duh). Seriously… why would anyone NOT follow directions to sit on one’s behind all day and just let the joint heal??? It’s the only smart thing to do, if I want my ankle to work correctly soon. So yeah. It all looked great, and I’m happy to hear that.

Once the poking and prodding was finished, they got me ready to put the cast on.

Note the angle my ankle was at. That was the angle I had been put at after surgery, and I hadn’t moved it. Not a smidge.

Then came the fun part. I had to get my ankle bent to 90* and turned slightly out. Turns out, it wouldn’t move much. I did what I could, but then the medical assistant had to finish it up. It hurt a bit – felt like I was trying to move my ankle through piles of sludge. Thick, concrete-y sludge.

Finally, we got my ankle where it needed to be, and it was casted up. I got blue. It was the only option. But blue is good.

Note the perty blue cast. And my orange toes.

Note the perty blue cast. And my orange toes.

This cast will be on for 2 weeks, and then it will be removed and I’ll be put back into a splint for another 3 weeks.

We took a detour on the way home for the best hot dogs in Maine – Flo’s. Yum. Luckily it wasn’t much of a detour, because I was in pain – we had to drive by it anyway.

That night, my in-laws came over with our nephew so that the boys could play together. Both boys were a bit put-off by the cast, but I think they were able to get over it when they autographed and colored it. They enjoyed that for sure.

autographed cast - lovely artwork!

autographed cast – lovely artwork!

I’m in the cast for two weeks, then back into a splint that will be able to be removed, at which point I will start physical therapy to get my range of motion back – currently, I have virtually zero. It was tough to be able to get my ankle bent to 90*, so I can’t imagine how it’s going to be after 2 more weeks of not being able to move my ankle at all. It’s frozen at this angle pretty well. But since this is the angle that the doc says will help me heal the best, so that’s what I’m doing.

I’m still going to have to stay off of it for the entire time I’m on the cast and in the splint, which will be a total of about 6 weeks. For that time, I need to use crutches. Another concern that I had had was the use of the crutches; last time I had surgery (3.5 years ago) I was 60lbs heavier, and couldn’t support my weight on the crutches. My shoulders couldn’t bear my weight. It was frustrating, it was obnoxious, it was annoying, and seriously – it was demoralizing. It was the heaviest I had ever been, and it was a daily reminder of my failings. Anyway. I have been using the crutches for a week – with absolutely no issues. No problems with my shoulders. No problems with my hands, or with my wrists. No issues climbing the stairs (backwards on my butt) –  last time, my shoulders dislocated. This time, nothing. It’s still early, I understand that – but after a week of absolutely no problems, I’m thrilled. And knocking on wood.

We have had a ton of help since I had surgery, and from the sounds of it, the extra help is going to continue. It’s amazing how awesome people have been. It’s awesome how much help we’ve had. People are amazing.

So far, so good. So far, no problems. So far, provided I keep up with the painkillers, I’m relatively pain-free. It’s good. It’s freeing. It’s a relief – and it’s motivating. I think that these last few pounds – once I can actually work out again, biking and walking – will be coming off sooner rather than later. And my ankle is healing. The turning won’t happen as frequently. It will be better. And it’s great.

How not to hurt yourself: a guide

It was late November or early December of this past year, and I was at work chatting at a friend’s desk. Chatting, standing, just like normal. My ankle turned, I cursed, and just continued on with my day. It hurt, yes, but it was nothing out of the ordinary; because of my Ehlers Danlos Syndrome (Hypermobility) (EDS), it happens often. I’m used to it by now. Fast-forward a few days, and my ankle is still bothering me (again, normal) but it’s more painful than normal. I purchased an ankle brace, and it seemed to help a bit. Fast-forward another few weeks or so. Ankle was feeling decent, and I was tired of wearing the brace, so I stopped. No issues.

Then the pain started. Again. With a vengeance. I can’t remember doing anything, so I’m going with re-irritation of the initial injury. Not impressed. Saw the doc, she suggested physical therapy and a RICE regimen. I asked if I should be in a walking boot, and she said it wasn’t worth the expense. I told  her I had one in the car – I already own one (from a past injury). She said absolutely, since I already have it – it was worth wearing it. We scheduled a follow-up for 4 weeks out, then went to schedule physical therapy. I started wearing the boot.

20130305-225953.jpg
That was January 25.

I had one physical therapy appointment, but because of the inflammation in my ankle we couldn’t do anything. It was a rather expensive icing session, and the physical therapist, who I have been seeing off and on for about 6 years, suggested I get a prescription for Prednisone to knock out some of the inflammation and pain. It did nothing.

Just a week later I’m in so much pain after running an errand that I’m in tears. It’s my right ankle, and though I have an hour commute, I had been driving in to work – not wearing the boot to drive, but putting it on when I get to work and then wearing it all day. That day when I ran out I was in and out of the stores quickly, but the pain was intense. When I got back to work, I called to schedule an appointment with the doc again; I was able to get in the next day. Doc recommended an MRI, which after much back-and-forth was scheduled for less than a week later, with the follow-up with a podiatrist almost two weeks after the MRI. Additionally, she suggested I stop driving; with the ability to work from home, I’m happy with the option to rest my ankle and not spend a fortune on gas for a couple weeks.

MRI went fine – I requested that the MRI report was sent to both the doctor’s office (standard) and directly to me, so that I could see what the issue was – see if I was imagining things as I was beginning to believe – and really get an idea of how badly I had injured myself. I received the report the Monday following the MRI (which was on a Thursday), and it stated that I had some swelling, and something called Sinus Tarsi Syndrome. I did my research, and it essentially said that I had simply turned my ankle one time too many. With such a report, I was comfortable with it – it would likely require an injection of some sort of corticosteroid, and I could mosey on my way.

I wish it had been that easy.

What the actual outcome is is so much more than Sinus Tarsi Syndrome – I actually ruptured two tendons – the Peroneus Longus and the Peroneus Brevis – and tore a ligament. There’s also some sort of debris in the front of my ankle – the doctor doesn’t know if it is bone fragments or scar tissue or fatty tissue (he equated it to chicken fat) – that will need to be cleaned out. So it will be a process. It will be a combination of arthroscopic (for the front) and open (for the tendon/ligament repair) surgery, so it will be rather extensive. I’m not looking forward to it. At all. I’m actually quite terrified.

The first three weeks after surgery I will be in a plaster cast, unable to weight-bear, unable to move my ankle. The three weeks following the cast will be spent in a splint – I’ll still be unable to weight-bear, but apparently will be able to start with range of motion and physical therapy. After that is a walking boot, and we’ll go from there. Of course, moving at whatever pace the healing will let me. I won’t be able to drive, which means I won’t be able to get to work. I have been lucky enough to be able to work from home for the last few weeks, and I should be able to do the same until I can get back into the office. I’m lucky to have a great work environment, great co-workers, and a great boss. It’s a relief to have one less thing to worry about. I just need to worry about the healing, and getting better.

Three and a half years ago I had my left knee operated on, and I ended up with an open wound, infection, and a long, arduous, painful healing process.  It was a horrible experience, and I hoped to never have surgery again. I was at my lowest point ever right after surgery – I spent most evenings sobbing my eyes out because I couldn’t deal with the pain, couldn’t deal with my shoulders dislocating every time I pulled myself up the stairs on my butt, couldn’t deal with the inability to be independent. I relied on my husband for EVERYTHING – I couldn’t put ANY weight on my foot, couldn’t shower on my own, couldn’t prepare my own meals.

I don’t want that to happen again, of course. I want it to be as smooth as a process as it could be. Of course.

There’s one big difference between last time and this time: little man. He’ll be 18 months old in a couple weeks, and he’s running circles around us already. He is an amazingly active boy, and loves to have us playing on the floor with him. One of his favorite things to do is to get a book and plop on the closest lap for that person to read to him – and then making the rounds to the next lap. He’s a whirling dervish  and this is going to be quite the experience. I love to be first and foremost the front-runner for munchkin’s care: I love to give him baths, I love to give him snuggles and smooches before bed. I love to get him jammied up and help him brush his little teeth and hair. I’m going to have to lean on my husband a lot more for the next couple months. We’re also incredibly lucky to have extremely supportive families. My husband’s family lives just down the road, and though my family is further away, they’re right here when we need them. It’s yet another weight off of our shoulders.

My main concern is that the surgery won’t actually prevent this from happening again; it’s only going to fix the issue for now. So yeah… I’m terrified that it’s going to happen again. And I’ll have to do the surgery all over again. I apparently should just figure out how to not hurt myself again.

That’s the key to everything: I need to figure out how to avoid hurting myself. When I was first diagnosed with EDS, the rheumatologist was real forthcoming: “if pain, then injury; be careful.” That was the extent of his guidance/notes/everything. I need to start wearing ankle braces ALL the time. I need to try and remember to keep BOTH feet on the floor and balanced, instead of keeping my weight on one foot more than the other. It’s time to start keeping myself in check. It’s time to start being careful. For me. For my munchkin. For my family.

‘Twas the night before…

Warning: some graphic content. If you can’t handle surgery photos, don’t look. You’ve been warned.

 

I’m still awake, but I shouldn’t be. We have to be up very early tomorrow morning; we have to be out the door no later than 5:30 am.

For the past few months, little man has been having ear infection after ear infection. Since mid-February, he has rarely been without one. Poor babyman has been on antibiotics more often than not, and for the past 7 weeks or so, has only been off of them for 5 days. We’re ready. Tomorrow morning, he will have tubes put into his ears. This will (hopefully) allow his ears to dry out, so that he no longer has the infections.

The tube itself is teensy.

(photo credit: http://entdoc-crc.com/FAQs.htm)

That is literally a tube sitting on a penny. It’s really that small.

So tomorrow morning, we’ll get to the hospital bright and early. We’ll go up to the outpatient same-day surgery area, and then they’ll prep him. We’ll have time to ask questions, and then they’ll put him under general anesthesia. You’d think I’d be terrified,  but I’m only a bit nervous. I know he’ll be fine, I’m just not looking forward to holding him as he falls asleep; I just don’t want it to be anyone other than me. I couldn’t stand not being there for that part. If they let me, I’d stay in there for the whole thing, but, well, they won’t.

Once he’s under, they’ll make a small incision in his ear drum, and insert the tube in the area. They’ll drain the huge amounts of fluid that just don’t want to clear up on their own, which I’m thrilled about. And then, voilà! He will be able to hear well again, and he will (hopefully) not get any more ear infections.

Essentially, this is the issue; it’s why he keeps getting ear infections:

 

(photo credit: http://earpopper.com/blog/an-ear-tube-named-eustachian)

What the whole thing looks like, side-view:

(photo credit: http://www.mayoclinic.com/health/medical/IM02073)

And here is what it looks like, with the tube in the ear:

(photo credit: http://www.earcentergreensboro.com/medical-education/ear_tubes.php)

All in all, I’m looking forward to getting it done. He had a slight fever earlier today, which is usually a good indication that he has another ear infection brewing. Here’s hoping we can get it taken care of before it becomes an issue.

Wish us luck. It’ll be over and done quite early.