May to December

I just wanted to bring you up to date on my fibula/ankle health. Since my last post in May, I finished physical therapy but have continued to do 80 ankle bend reps of a triple folded green theraband daily. Consequently about six weeks ago I realized that my recovering right ankle was actually stronger than the left one. Since then I have been doing the 80 reps on BOTH ankles. Although strength is good, my recovering right ankle continued to be so sensitive to anything touching it that I have been limited to wearing shoes that are below the ankle. Even certain types of socks have been a problem. Dr Hinz warned me at the time of my surgery in March that I would likely want the plate and screws removed but I had not realized then just how much of a skin sensitivity issue was going to follow.

Well with about 18 inches of snow on the ground in Sunriver and boots out of the question, the plate and screws had to go! I had my hardware removal surgery last Thursday (Dec 16th) and I will be hobbling around in my big black theraboot for about another month. The incision area is still tender, but it is improving every day so I’m very optimistic. I’ll have my sutures removed on the 29th, I’ll post if there is any interesting news.

When I last posted it was still a mystery as to how I could have had normal Dexascans for years and at the same time had Dr. Hinz tell me that my bone felt somewhat soft. Mystery solved – my Dexascan results now show some osteopenia. I’m putting a picture of the results on the blog because hindsight I should have looked and seen the obvious; the densities (BMD) and T-Scores have been trending in that direction since 2000. As yet my hip still shows as normal but unless I can intervene with more resistance exercise, it is likely to dip into the wrong direction as well. The other mystery was, can some bones be denser than others? It is pretty clear from these results that the densities can be very different depending on which bones are scanned. I’ll be seeing my regular physician in January and I’ll let you know what she recommends as follow up.

Have a wonderful Christmas, ours will be pretty quiet.

I'm Getting There

Hi Everyone,

First, my tip; throughout my recovery I’ve been down on the floor doing various stretches and yoga postures most every day. Just in the past two weeks I’ve discovered a much easier way to lift myself off the floor assuming minimal weight on one foot. Instead of using your hands (on something solid) and your “good” leg/foot to lift, use your dominant fore arm and the other hand. What a difference!

I had my last visit with Dr. Hinz (ankle surgeon) May 3 and he said all was well. He does not need to see me again unless I want him to remove the plate and screws once the bone is totally solid in four to five months. Six weeks ago I would not have considered going through another post-surgery healing process, but if after several months, the skin over the plate remains as sensitive – maybe.

I’m doing two PT sessions per week with Brent at Mavericks, the only negative is that one is always on Monday morning (he does not work on Tuesday mornings) and it conflicts with my wonderful Women’s Spirituality group. As soon as my ankle is strong enough to have my sessions on land (versus pool), I’m sure I’ll be able to switch to Monday afternoons. I’m doing pretty well, driving comfortably but still walking with a limp and just for short distances. My problem in this area is discomfort on the top area of my foot; I guess the muscles atrophied from being in the splint/cast for several weeks.

In follow up to the potentially soft bone issue I mentioned in an earlier post; I’ll be waiting till my next scheduled Dexa Scan in November for my answer. I would have been happy to pay for an earlier one if Dr. Hinz thought it critical, but he thinks November is fine; in the world of medical tests, Dexa Scans are relatively affordable at around $260. Most insurers cover one every two years, unless there are special circumstances, such as taking bone density meds or bones breaking with very little effort. I also attempted to get the opinion of my internal med doctor on the “Should I get a Dexa Scan now” issue, but got very little in the way of advice. The other debatable Dexa issue is “Are all your bones of equal density?” As you may recall, I had several years of normal Dexa Scans, then, after my surgery, Dr. Hinz told me that my bone felt somewhat soft. Dr Hinz and most medical articles indicate that your bones are all equally dense, but some of you have told me that you have heard conflicting views, so I think the jury is definitely still out on this one.

Two Months

Crunch and twist day was two months ago today – Feb. 25. As of Friday things are going fairly well. The two weeks prior to that however, I battled a sinus headache that caused me to miss my first full week of physical therapy; so tomorrow I’ll attempt a full (two session) PT week again. It has taken me quite awhile to get this walking cast/boot working for me instead against me, but I think I’m finally there. The issue is lots of skin sensitivity at the surgical site (ankle), actually over the plate. I’ve modified my “socked” foot with Nu-foam cutouts I made (photos) and it is finally reasonably comfortable. I found this material at Jo-Ann’s Fabric; it works much better than regular foam. I made room for the cutouts by removing some of the unattached pads in the cast/boot.

I must admit that it has sometimes been hard to find the bright spots these past two months, but I just have to share this one. Many of you know that I’ve had lots of challenging times dealing with my mother since my dad died four years ago. Even when she entered Aspen Ridge and received more specialized care this past New Year’s, things were still rocky at best. Because of my physical limitations concerning this injury, I have really cut back on my visits to her and she seems to be doing much better as a result. She now relies on the Aspen Ridge staff for company and seems generally happy. I took her to the eye doctor on Wednesday and she spent the entire visit singing “Over There” (a WW ll song). It made for an interesting appointment, and completely tired her out. Dr. Lewis seemed to cope remarkably well.

Big Day

I saw my doctor today and received lots of good news. I am now rid of the HORRIBLE cast, it was really getting uncomfortable; I now have a strap-on walking cast that can be removed for sleeping, showers and when I am just sitting around -I've attached a photo. I have an Rx to begin physical therapy and I'm free to get around as much as I can with or without crutches just using pain/lack of it, as a guide. The fibula is healing well, I've attached the Xray (front and back views) showing the plate with the screws going through the bone. It looks like a screw is loose, but that is just the camera angle. I'm now at week five past surgery but week six past accident, and my first step down onto "the foot" hurt all the way up to my brain!!! Al said that this extreme sensitivity when nerves, blood vessels and muscles have not been used for sometime is very natural. Sure hope he's right.

Hotel opinions

Al and I just returned from a short trip to Calif. for taxes (our long time accountant) and way too brief family visits. I decided to try the road trip at the last minute since I was not sure how difficult it would be to travel with my foot in a cast navigating hotels, restaurants, etc. Should you ever have to do this for yourself, family or friends, I thought I’d share my hotel opinions with you:

Red Lion in Redding, CA (great for disabled traveler)

Marriott in Walnut Creek, CA (difficult for disabled traveler)

Cupertino Inn, Cupertino, CA (next to impossible for disabled traveler), does not deserve a rating although it is considered a high end hotel.

Shilo Inn, Klamath Falls, OR (great for disabled traveler)

We had requested and received rooms with handicap access from each of these hotels.

And speaking of pain pills...

Al and I use mail order for nearly all of our perscriptions, our insurer requires it. However, when you break a bone, as some of you know, you need a heavy duty pain pill - no waiting. In the past I've usually used Walmart, Costco or Fred Meyer as local pharmacies when necessary, and put up with anywhere from a half hour to multiple hours wait when I've left off a new perscription. On the day of my accident Al and I were in the Shopko area following my "splinting" so that is where we took my new pain pill Rx. Ten minutes in and out, no waiting. After my surgery the following week, another new pain Rx, back to Shopko we went. Ten minutes in and out, no waiting. I'm almost afraid to try again; I just can't believe we were this lucky or that this pharmacy is so much faster than the others. Just thought I'd pass it along.

Splints, it's a skill thing

When my doctor told me I would be I would be getting a splint right away, I had no idea what the splint of today is. It looks like a massive bandage or soft cast around your foot and up to your knee. I had four splint changes to accomodate ankle swelling/size changes. Three of the splints were applied and wrapped correctly so the discomfort was tolerable with pain pills; the fourth splint was applied by a tech who was obviously very inexperienced. If you ever have to get a splint in the ankle area make sure the tech presses hard enough to seat it onto your heel, and does not otherwise interfere with the splint seating onto your heel. If your heel is unable to reach the bottom of your splint ,once it hardens, it pivots and rubs on your ankles.

Knealers, the good and bad

Knealers are a good alternative to crutches, most of the time. They don't do steps so you will still need crutches occasionally. Here are some need to knows about knealers:

• They rent for about $140 per month and most insurers don't cover them.
• They are NOT as stable as you may have been led to believe, they can and do tip. This might have been prevented had I been given more than the most basic instruction or at the very least, a manual. Despite the warning sticker on the knealer, to "Read Users Manual Befor Operating", they did not have one for me. Also when I asked the therapist for more hands-on instruction, he just blew me off with "that's advanced" and left the room. I'm not thrilled with Summit Therapeutics at the Center.
• After about a month, I'm doing pretty well with the knealer I have, but it is quite heavy for getting in and out of the car.
• When you reach the stage of having a hard resin cast on your lower leg, kneeling on it is very painful unless you slip some foam down the front of your cast.

Bone Density True/False

For years I have had GREAT Dexascan results; very healthy dense bones at the density equivalent of someone 30 years younger. My internal med doctor and I attributed this to a generally healthy life style for bone density-how smug of me. Coming out of anesthesia from my fibula surgery my surgeon told me than my bone was somewhat soft for someone who is as active as I am. Shock. How could this be? Well, it is; once I can walk again, I'll go back to my internal med doctor and likely start osteoporesis meds, since they generally require walking for a short period after taking them. I still can't figure this one out, since the Dexascan reviews on the Internet look solid. I'll keep you posted once I learn more.

Shower Appreciation

Today was REAL shower and shampoo day, that is, not done standing at the sink balancing on my knealer. For the rest of my life I vow to appreciate every part of a real shower, including being able to take one whenever I want without having someone else help me. Although I would not recommend breaking a leg/foot bone then having to go through the recovery to anyone, it sure leads to a lot of appreciations for things you barely noticed before. When my Dad died four years ago this week, he was, physically, a complete invalid. I just can't imagine how he managed to stay so cheerful and appreciative of even the smallest blessings in his days. Take care out there and notice things!

My First Post

Just about a month ago my ski slammed into deep snow; I however, kept going forward. A crunch in my ankle and a dull ache was confirmed in the next couple of hours as a broken fibula. My first ever broken bone. It seemed oddly glamorous for the first few days, those feelings are now waaay over.

After waiting a week to see if the bone would move back into a good position for healing on its own-it did not- I had surgery with screws and a plate to hold it together. I continue with NO weight on it, scooting around on my knealer and really looking forward to April 7th when I get a different cast that supposedly will allow for a little weight. I'm hoping to find some of you who may have been through this kind of thing and can give some of your thoughts on related issues that I can't find answers to. Such as:

What are some safe movements for the rest of me that I can do now?