Well - you do still have arthritis (or -16 with 50mph winds)

OK, so all is not peaches and cream.  Not complaining - exactly.  But yes, when the weather is minus double digits and the wind is whipping, the ankle is achey and stiff.  It has not been particularly happy since the white stuff arrived in October.  Still doesn't handle the uneven surfaces very well.  I discovered there's a reason the PT gave me all those tip-toe and standing on one leg exercises.  Some of the tendons and ligaments haven't had to work in years, and they're very lazy and weak.   So, you put on snow boots and head out into this moon surface stuff, and your ankle wants to roll out from under you.  Dug out the exercise sheets and back at it.  My chiro suggested a few weeks of walking in warm sand.  I asked if he'd write a prescription.  Just enjoy the thought of what VA's response to that referral would look like after our year-long battle.

Overall, delighted with the results of the surgery.  Seems unreal its been almost a year already.  Looking forward to spring and more solid footing.

A 2 Mile Hike

Yes, you read that correctly.  Friday I was able to do a 1/4 mile with the dogs.  Hubby has been busy teaching, and we have a new 1yr old, so walkies are a necessity.  So, my first solo dog walk in almost a year!  Saturday we did another 1/4 mile, and then I went with my mother-in-law to check out the craft stores.  It felt amazing to be able to just go whereever we wanted and not have to consider how far we'd walked, how far away the parking lot was, etc.  Just like a normal person!  I had a totally pain-free day Saturday.  Narry a twinge.  It was incredible.  Sunday I figured I better take it easy, but it was one of those amazing, you should bottle it kind of days with sun and blue skies, so carpe diem.  When Ben suggested a walk to the river, I said yes.  Two miles on trail, with hills and roots.  My legs were shaking like noodles by the time we got home, but it was such pure joy to be able to do this walk again.  I haven't been down to the river trails in two years and have really missed watching the different wildflowers bloom, and checking out the changing sandbars.  The dogs ran like they had firecrackers up their butts.  A very good day was had by all.  And, I could still walk on Monday.   Actually, my back and hips are more sore than the ankle.  I just want to call everyone in the phone book, whether I know them or not, and tell them what I can do!

A simple walk in the rain

We all know we should slow down, enjoy the simple things, and stop occasionally to smell the flowers.  This week I got to experience the simple pleasure of a walk in the rain with my dog.  It wasn't very far, it wasn't very fast, but it was absolutely delightful.  I am so pleased by the progress so far, and excited about the future possibilities.  I'm now walking without any aids.  When people started bringing me my cane because I'd forgotten it somewhere, I decided it was time to put it in the closet - hopefully for good. 

Sat. we set out to do my PT homework for the week - determine how far I could actually walk.  As a precaution, I put on my leather gauntlet brace and my hiking boots.  Felt like a turkey trussed up for Thanksgiving.  I managed 1/4 mile my first attempt.  That included a short section off-trail, with a hill.  Going up was no problem - a HUGE change from pre-procedure.  The extra dorsi flexion is really paying off there.  Downhill was a bit trickier.  I think I just need to stretch things the other direction now.  I did feel very stiff, more like a popsicle stick guy than a Gumby guy.  Like, if I stepped on something uneven I'd just break instead of flex.  Sunday we went up Hatcher Pass and I decided to leave the gauntlet at home and just go with hiking boots.  I took a short walk up an actual mountain trail, just far enough to see over the other side.  Walking was much easier without the gauntlet and I felt much more able to flex with the changes in the trail.  My husband was taking video and even captured me walking back to the car.  I was hugely impressed by how even my gait looked.   Wasn't fast, but it was pretty fluid.  I'd like to screen capture that video and shove it down the throat of every VA doc who insisted we had to fuse this ankle.  Yeah, yeah, still working on that zen thing!

When we got home Sun I stood in the kitchen and made a cake.  No additional swelling.  No increased pain.  Certainly some stiffness, but 10-20 min of rest and its ready to go again.  It's not painfree by any means, and maybe never will be.  And I don't know how much of this is physical and how much is just an attitude shift, but now when I feel pain I think, oh, well, that's not so bad, feels better than a week or two ago.  Before the procedure when I felt pain it was, oh, see, the thing's falling apart.  Attitude really is a huge component of this whole procedure.

So, I'm 2 months into what is normally considered a 12 month rehab, and I am delighted by the progress.  The first few steps each time I get up can be quite painful, and sometimes I have to stand a few seconds and just shift my weight back and forth.  Quite amusing at the library when a patron is waiting for me to retrieve a book.  I'm hoping that dissipates over the next few weeks.  I hope to continue PT for a few more weeks, as we're just starting to work on balance and gait.  I'm looking forward to increasing my endurance over the fall, and wishing I didn't have this invisible timeclock ticking away signaling the end of outdoor activities and the beginning of six months of hybernation. 

The tortoise

Continuing a slow but steady improvement.  My PT assures me its better to be the tortoise now than the hare.  Seem to have little spikes of improvement the day after a pool session.  Now primarily just using the cane unless I really overdue it during the day.  Still not much endurance, but strength coming along nicely.  ROM improving a couple cm a week right now.  Have just a little more dorsi, first thing in the morning, than pre-procedure.  A little less by evening because things are stiff and swollen.  Starting to get out and run errands on my own a bit more.  Walked across a grass lawn today at the library's summer reading program finale picnic.  Very tough, just that bit of uneven ground, but I did it.  Paying for it tonight, but I did it.  And still doing everything w/o a brace.  So that in itself is an improvement.  Think I'm going to tackle a return to yoga next week, since I can get off the floor now without having to do the dying cockroach roll onto the couch.

Swimming

Finally got to go to the pool.  Little tricky getting in and out with crutches.  Have to be very careful of the slick floor.  But once in, it felt great!  Able to walk between 4' and 5' marks.  Even did some flutter kicking.  Really have to concentrate on allowing the ankle to be soft, and it takes a lap or two to warm up, but for a few moments I was outpacing the toddler swim class.  First few steps walking are quite painful, and still mainly using 2 crutches.  But discovered once I'm warmed up around the house, I can 1 crutch it pretty well from room to room.  Even managed a voyage from kitchen to living room and back w/o crutches.  Only been a month - not the 6 they recommend, but I'm ready to declare it a 90% success.  Really feel there's more freedom of movement in the joint, and certainly smoother and more fluid.  Once the ROM releases and the healing pain subsides, I think I'm going to be a happy camper.

14+ weeks

PT continues.  I actually enjoy it.  After not doing anything for 12 weeks, it feels good to move things.  ROM increases slowly ... but measurably, which is what counts.  Ankle got T-boned on my knee walker Wed at the library by some out of control kid.  He was lucky to walk out under his own power.  Really sore Wed and Thurs, but no damage done it appears.  I discovered Friday that I can 1 crutch it for a few steps, or even use a cane.  But it doesn't last long.  Has made it easier in the kitchen.  I don't strand myself as often.  Going to take the regular walker to work tomorrow to use while there.  Try to leave the knee walker at home for late night potty runs only.  Hoping to hit the pool this week.  Otherwise, just keep on hobbling along.

PT

First PT session.  They're already planning to ask the VA for an extension.  I guess they figure its going to take us more than 8 sessions to get from here to there.  My whole body is achey tonight, but it felt good to move things again.  Still no dorsi flexion, but plantar has returned to nearly normal.  My 'good' knee is a swollen unhappy camper.  Not injured per se, just exhausted.  Trying to weight bear with crutches has made life harder for it the past few weeks.  Not fully weight bearing.  PT did say I could transition out of the Frankenstein boot whenever I wanted, as long as OK with my doc.  So I came home and put the darn thing in the closet.   It doesn't encourage me to use dorsi flexion, and wasn't relieving any pain I could notice.  Transition complete.  Still using knee walker at work, because I'm useless on crutches.  I save them for weekends and off time.  Coming along slower than I'd hoped, obviously, but not surprisingly so.  It does improve incrementally every day.  Still hoping to be down to a cane by July 4th weekend.  Just my own personal carrot.

Melt Down

I suppose it was inevitable.  I've tried so hard to remain positive and flexible through this whole thing.  But, a week out of the frame, and I just can't get over the idea that a walking boot meant I could walk.  Reality is somewhat different.  So, still using the wheelie and ankle is stiff as a brick.  No pain - as long as I don't try to move it!  Yesterday I had my husband set me up on the front deck with my newly purchased flowers and my hanging baskets and dirt, so I could do at least a little gardening.  In Alaska, this is a really BIG deal every spring.  And about halfway through the project, I needed things that weren't there in front of me.  He, meanwhile, had gone off to do something else and couldn't hear me call for him.  So, then I tried to get up off the deck, only to realize it was too low for my poor tired "good" knee to support.  So there I am, stuck like a turtle on its back, surrounded by plants I didn't want to crush.  Not a pretty picture.  I did finally manage to get myself up and back in the house, where I promptly had a meltdown worthy of any 3 year old.  So I sent myself to bed, dirt and all, pulled the covers over my head, and slept for 45 minutes.  I woke up feeling better and decided I could probably tackle the gardening again tomorrow.  I guess the point is, this ain't over till it's over and the fat lady hasn't sung yet.

I have a JAS splint on order that will assist me in regaining my ROM, and am waiting on my PT authorization to be approved.  I'm fairly confident that once I can get into the jet tub or pool things will loosen up more quickly, but that's still several weeks away.  Meanwhile, I have to accept that I'm still reliant on the knee walker to actually get around, and just keep trying to stuff my foot into the boot at home and make voyages up and down the hallway.  Grrrrr....

And then there's all the helpful folks who keep saying "oh, you must feel so much better without the frame" and "what did the doctor say, is he impressed"  I know they mean well and I do appreciate it.  But the truth is, no it doesn't feel better out of the frame because the frame was supporting the ankle joint.  I don't miss the pins or sleeping in it, but I do miss the support.  And the doctors didn't say anything because from here on out, it's a total Hail Mary pass and it's going to be awhile before we know if anyone caught the thing anywhere close to the end zone. And this week, that end zone is a long way away.  So, I just smile, grit my teeth, and say "Yes, feeling better, thanks."

Cage Free!

Frame came off yesterday.  Very quick, simple procedure, which I slept through.  Foot pretty achey, with some sharp pains in the inside heel area where the heel pins were.  They have it compression wrapped for air travel, so I can't do much with it until I get home.  Then walking boot for two weeks, and whatever feels good thereafter.  I haven't tried walking on it yet.  With the compression wrapping, the boot is pretty tight and uncomfortable, and puts stress on the bones if I wear it while using the knee walker.  I decided to stay off it another couple of days and get as much swelling down as possible before travelling home.  Then I can experiment in the comfort of my own home.  Sleeping is really nice without the frame.  I don't wake up to readjust pillows and props every time I change positions.

Counting Down

Yes, I'm counting days.  8 and a wake up to be exact.  Past few days pins have been hurting all the time.  I sneezed yesterday and nearly cried at the pain.  Strange since its all been fairly pain free.  But others have told me its like this when the end is near.  The pins are ready to come out.  I skipped ROM and weight bearing yesterday.  Just tried to keep the foot really still and iced.  Even hitting small irregularities on my scooter was painful.  Today a bit better, but still stinging pretty good.  And I'm tired again.  Suddenly sitting with the foot up and taking naps again isn't such a bad idea.  Very interesting the phases this process goes through.  Looking forward to joining those of my on-line chat buddies who've recently had their hamster cages removed.  Really looking forward to moving the body again, in whatever capacity.  Feeling confident this part of the process has been successful and will work.  Anxious to hear what kind of physical therapy is in store.

Cinco de Mayo

Not sure what that has to do with ankle distraction - I just like saying Happy Cinco de Mayo.

Not much new to report this week.  Didn't have to go to the doctor, which was a nice relief.  Doing my own pin care since my nurse neighbor went on vacation.  Need longer arms for those outside heel pins.  But everything looking good.  Talked with Phoenix doctor and he only plans to remove frame while I'm there.  Leaving permanent pins and spurs alone for now.  Was able to call and arrange a knee scooter for the week I'm there.  So, now just continue ROM and weight bearing for a couple of weeks and then we'll see what's in store during Phase II of this project.  Had a chiropractic adjustment yesterday.  Seems to have done wonders for the attitude. :)  Also fell yesterday.  Just stood up, lost my balance, and realized I was going down and had to hold up caged foot and not fall on dog in the process.  "Good" knee hit pretty hard, but it still works so I guess we're OK.  Like I said, the going slow thing has gotten old by now and it's hard to be patient with myself.  Guess this was a sign I need to pay more attention.

Still Cooking

Week 6 - just 3 to go, and yes, I'm counting!  Doing better this week.  Really hoping I'll be able to start walking once the frame is off and the walking boot is on.  Persuaded the doctor that we could pass on the last injection and not negatively affect the outcome.  I think he's as tired of trying to find the joint space as I am of getting poked.  So, just x-rays and re-dressing from now until frame removal the end of May.  Doing lots of visualization of joint space and cartilege rebuilding.  Pin sites look good.  Range of motion doing OK, in my opinion anyway.  Weight bearing OK.  Just keep plugging away.

Boredom

For the past week, my main feeling has been boredom.  I'm tired of dragging around the hamster cage and tired of everything associated with it.  The unique-ness has definitely worn off.  Its getting harder to be patient with myself and do things slower.  I'm tired of telling everyone I'm doing fine and there's nothing new to report.  I'm tired of wearing the same two pair of pants!  Its hard to force myself to take the down time I need to be fully rested.   My husband has taken to putting me down for a nap daily!  If I don't go willingly, he threatens to take my wheelie away from me.  I'm ready to get this thing off and start some serious physical therapy biking.  Just another stage in the process, I'm sure.  One of my fellow frame wearers gets his frame off today.  I'm very anxious to hear about his experience.

ROM going OK, I guess.  Don't really have anything to measure it against, but it increases every few days by 1/4" or so.  The joint is moving, and without much pain.  Mostly its the heel pins that prevent me from doing more.  Weight bearing is going fine.  I'm convinced I could walk with the frame if it weren't for the heel pins.  I'd also probably be tripping over it every other step!  The joint pain is minimal compared to pre-surgery.  So I think the frame is doing what its supposed to do.  Just trying to maintain a good diet and positive frame of mind, so the body makes that holy grail cartilege that will allow some pain relief when the ankle no longer as this suspension bridge to support it.  I really think if there was a Star Trek device to miniaturize this whole contraption, so it could be installed internally, we'd have a permanent fix to the problem.

Balance

Played hookey from ROM and weight bearing yesterday.  Heel pins just too sore to want to move anything.  Today played hookey from work so I could concentrate on ROM and weight bearing.  Bottom line is, think I overdid it this weekend.  Trying to find balance between normal activities and extra rest; and between taking or not taking pain meds.  I suppose by the time the hamster cage comes off, I'll have it all figured out.  ROM did improve today, so yesterday's hiatus might have been a good thing.  Up to @1.75-2" total movement measured against the hinge rod.  Not normal, but moving smoother and improving steadily.  Think body still needs several hours down time couple of times a day.  I tend to forget that riding in a car or being on the scooter counts as activity because the foot is down, not elevated and resting.  Just as being at work, even if sitting with the foot propped, isn't the same as being at home with it elevated.  Another doc appt. and injection tomorrow.  Only counting how many injections are left - not how many days in Hamsterville - yet.

Fourth Appointment

Doc finally has a routine down that is providing tolerable joint injections.  Requires numbing the skin, then numbing the muscle, then doing the joint injection.  But, whatever works is good by me.  X-rays show consistent joint space.  ROM is proving a challenge.  Makes the heel pins very unhappy campers.  But my nurse neighbor has suggested a new routine of pain meds that will hopefully help.  Hard to pursuade yourself to do ROM when its painful.  Otherwise, all going well.  Feeling a bit stir crazy and bad case of Spring Fever.  Would love to get out and walk dogs or bicycle.  Just keep thinking how good it will all feel when its done and how much more pleasant the fall walks will be this year.  Fingers crossed.

Range of Motion

Got an e-mail from my doc instructing me to begin range of motion and weight bearing.  You just gotta love modern technology.  Must admit, pretty intimidating to unlock the frame for the first time and try to move this thing you've been protecting so hard the past 4 weeks.  One of the down-sides to trying to do this long distance.  I think there's a great psychological comfort in having the doc tell or do these things to you in person.  At home, I just have to trust nothing is going to fall off!  Also have to admit, not much motion.  Lots of stiffness, and lots of pain trying to dorsi flex.  I have some serious work to do over the next 7 weeks.  Since we're still a few days shy of a full 4 weeks, I decided to ease into the weight bearing by having it on the floor when I sit.  The "weight" is just the weight of my leg.  Achey-est day so far.  But as with everything else, should improve with time and patience.

Really wish I could go to the pool, or at least soak it in the jet tub.

Week Three

Everything looking good.  We've decided the redness was an allergic reaction to the betadine, and its much improved this week.  Pin sites look good.  Very little pain most of the time.  Joint injection was much less painful this week.  I takte that as a hopeful sign that the joint is adjusting to having space and fluid in it again.  Mostly its just a bit of a hassle dragging around a hamster cage.  Hard to get comfortable anywhere but in my own home.

The Hamster Cage

Had my neighbor, a nurse, come over yesterday and inspect and clean the pin sites.  Finally remembered to take a photo while the hamster cage was naked and exposed.  We're trying to figure out what the redness is.  Looks and feels more like an allergic reaction than infection.  Pin sites themself look good.  Taking precautionary antibiotics just in case.

Overall still feeling good (unless I think about the next injection).  Bit worn out physically and a bit restless.  Hopefully returning to work a few hours next week will help.

Second Week Follow-up

First set of post-op x-rays.  Beautiful joint space!  Seems the fixator is doing what its supposed to do.  Disappointing, but developed slight infection.  Seems more of a skin irritation to me.  Not unusual with all these pins, but still disappointing.  Had my first joint injection of Synovisc.  I expected it to be painful.  I didn't expect it to be the worst pain I've ever experienced.  Poor nurse.  Was standing too close to my good leg and he'll be speaking in soprano the rest of today.  It's going to be difficult to prepare for the next two visits, knowing I'll be getting another injection each time.  But I actually had to fight to get these administered, as the VA here does not approve, even though they were ordered by the Phoenix VA.  I reminded myself that I had begged for this as I was turning purple and swearing like a sailor.  My hope is that since the joint has been so collapsed for so long, as it adjusts to having space and some fluid, perhaps the pain won't be as bad next time.  The trial results on injections in the ankle vary greatly.  So, it's not a necessary part of the treatment.  But my doctor in Phoenix does believe they help, and after fighting so hard for so long to get this procedure, I want to cooperate and do everything possible to assist in a successful outcome.

I'm feeling well enough to want to go out and about, like have dinner with friends.  But I find it impossible to get comfortable anywhere but my recliner or bed.  My recliner and my butt are becoming much too friendly, I'm afraid.  The foot doesn't hurt, but there's just nowhere to put this hamster cage without putting pressure on the knee, or the hip, or the back.  Riding in a car any distance is the same issue.  The foot isn't happy on the floor for very long at a time.  You cross your legs, your foot falls asleep.  You put it on the dashboard, your hip falls asleep. 

I traded in the speed racer knee scooter I had rented for a little old lady model furnished by the VA.  At first it was disappointing.  Can't get nearly the speed with the new model.  But it has the advantage of folding up completely, is lighter weight, and turns in a much shorter radius.  It's much more practical for a small living space, like my house, and I think my husband would be relieved if I quit taking off the baseboard molding every time I ventured to a different room.  The knee scooter is an absolute must, I believe.  Crutches would severely restrict my activities and my independence, not to mention my arms would have fallen off by now.

I tackle the issue of clothing this week.  If I want to return to my job, even on a limited basis, next week, I need something to wear other than shorts or side snap sweats.  So I'm using the sweats as a pattern for side snap pants.  And of course, I'll need matching T-shirt footbags.

First Post-op Follow-up

Just returned from first post-up follow-up appointment with Anchorage VA.  You realize how sadly compressed your life has become when you look forward to a doctor's appointment as an excuse to get out of the house.

Pin sites look healthy.  I have to admit, I did "swoon" when they unwrapped this package for the first time.  Watching on-line videos of someone else's leg is a bit different than seeing these big honking rods going through your own leg.  But I am on blood thinners.  That must be a contributing factor.  I really can't be that much of a wimp.

I am convinced this was all designed by a couple of good 'ole boys in the garage one night after a six pack.  It is quite the erector set.

Pain meds doing their job well.  I'm able to start cutting back and often sleep through a dose.  Sleeping quite well considering this additional appendage.  Maddie the cat has become adept at curling herself into my lap without tweaking anything tender.  Purr therapy must count for something in all this.

Picked up a knee scooter today.  A bit painful to put weight on the tibia, but the tibia rods have been a bit tender the last day or so.  Sure beats waggling about on crutches.  I guess its either sore arms or sore leg.  The scooter has a basket, so I can actually carry things from room to room.  Does pretty well in my small house.  I imagine the cat will be riding around in the basket in no time.  I got up some impressive speed with it along the long tiled hallways at VA.  All the old guys were jealous.

The side snap sweat pants worked great for appt today.  Can't get anything else over it but shorts at this point.  Also found that the foot bags I made out of men's T-shirts are working well to keep the foot covered, prevent damage to furniture, and keep the gawking to a minimum.

Seems like all I need to do now is rest and heal for another 3 weeks.  Then we loosen the hinge on the frame and begin dorsi-flexion and weight bearing.  I think I could get used to the mid-afternoon naps.