Weight Bearing, Walking, Swimming

On Friday, February 11, 2011 I took my first steps (in my walking cast / boot thing)! I tried first thing in the morning but it hurt a lot so I waited until I was at physio therapy and started walking there ... still using my crutches for support. I was advised to go heel, toe as I walk with my boot on. I was also told I could start using just a cane the next day (Saturday, 12th) which I did! It went fast from there and now I can walk short distances without the cane and go for 20-30 min walks with the cane. It still hurts for the first few steps but then gets better and then eventually gets bad again. At the start, the most pain is the very bottom of my heel then that subsides and the pain that comes later is at the back of my heel. After consulting with my physio therapist, I've learned that this pain is actually in my achilles tendon right where it attaches to the heel bone. I have some tendonitis there which apparently is normal when one starts weight bearing. I have to keep doing my stretching, massage it, and ice it.

We spent the Family Day weekend in Florida visiting my parents and it was there that I really started walking well. We went for walks on the board walk, the beach, at the Daytona 500 raceway ... and sometimes for 30 minutes. I learned that I can go longer if I pump air into my cast. It seems to take some pressure of the achilles tendon.

I went swimming for the first time on Sunday, February 13 and the Gators were very good to me!! I used a pull buoy for most of the swim but did some one-leg kicking and dolphin kicking from the hips. I swam 2000 metres which was a good start. I also swam Tuesday, February 15 with the Gators. In Florida, I swam every day either treading water in the deep end with the kids or doing lengths with my new friends, Maureen, Beryl, and Hazel. Swimming is very good for my foot. The swelling goes down and it feels much less tight afterwards. The only pain I feel swimming is on the damaged nerve area where just having water flow past it feels sore. In Florida, I even walked barefoot on the bottom of the pool as normally as possible in the deeper water.

One down side to flying to Florida was that I had to inject Fragmin in my stomach before and after the flight each way to prevent blood clots. I was apprehensive but it wasn't difficult at all and didn't even hurt (except a slight stinging for a few minutes after). Only one of the four injection sites bruised.

But, we had a great time visiting with my parents and celebrating Family Day with them. It was an excellent trip recovery-wise because my ankle got lots of exercise in the water and on land. I can't wait for the snow to melt on the sidewalks so I can go for a walk outside in Toronto.

My Human Foot

I want to try to express in words the evolution of feelings I've experienced about my foot.

For a few days after my surgery, in my mind and in my dreams, my foot was normal (well, as normal as my pre-surgery foot was!) I remember wondering when I would start dreaming "on crutches". It didn't take long. Soon (within days), in my dreams and imaginations, I was on crutches and soon after that (within about 3-4 weeks), I was unable to even imagine myself walking on my foot. In fact, if I closed my eyes and tried to imagine standing on the side of the pool (or on the starting blocks) and diving in, I couldn't. I couldn't even imagine starting to swim from within the pool.

I've been doing physio for almost 3 weeks now and soon I can start putting weight on my foot (2 days ... but who's counting?!) The process of physio and my three-times daily exercises has been gradually turning my foot back into a human foot! I can feel it. For about a week now I can imagine stepping on it! Sometimes when I have my sock off, I put my foot on the floor to feel the floor (well most of it ... heel is still numb). I also like to put my bare foot on the cold wall in my bedroom or the cold tile in the bathroom. Or when I'm lying on the couch I bend both knees and put both feet on the couch underneath my knees. Sometimes when I'm sitting down about to stand up, I almost accidentally put my right foot down! It's like my brain is getting ready to accept my foot as working again. This isn't something I've done consciously or even worked at doing. I've just noticed it taking place almost as if it's happening behind my back!!

Next step, standing (on both feet), walking, and swimming (not necessarily in that order) ... how I long to be in the pool!

Physio Update

I had physio therapy today and it was really good! I asked about weight-bearing and if I should be getting ready for that. He said that I can just start on Friday when I feel comfortable and in my house to start where it is safe. He also said that he expects I won't have a lot of difficulty because the swelling is minimal and the range of motion is good! This was great news for me because it is hard to tell when it is your own foot! I also got a red thera-band so I can start doing my exercises with some resistance. He also suggested I put a towel on the floor and a book on the towel and use my foot to move the towel toward me and to the inside. I have also been picking up marbles with my toes (it's pretty easy!). I am excited to have more exercises to do. I finished my physio with a bike ride: 15 minutes on level 5! Pretty exciting! Four days to putting my foot down!! Six days to getting into the pool!!!

52 days post-op: Picture comparison

I have been doing physio for 2 weeks and I'm 52 days post-op but still non-weight-bearing. I won't really know if things are working until I start weight-bearing.

I wanted to compare the progress because I feel like my foot is getting less straight and less arched. Here are two pictures from the back. In the first one I'm standing and in the second one I'm sitting with my feet on the ground (since I can't stand yet). Picture 1 from the day before the surgery. Picture 2 at 52 days post-op (7.5 weeks). There is still a lot of swelling it seems. Trying to stay positive ...

Keeping my Spirits Up

I had a fairly busy weekend and was able to see a number of people and had some excellent visits but Donny works on the weekends so I'm left on my own pretty much all day barking orders at the kids (which they don't much enjoy): can someone please walk the dog? could you please make me tea? please throw in the dark load of laundry and hang it up. please unload / load the dish washer. etc. As you can imagine no one jumps up and does it the first time they are asked. It gets frustrating!

When I imagined being non-weight bearing for 6 weeks (which has now become 8.5 weeks), I imagined doing stuff but on crutches. The one (obvious) thing I overlooked is the fact that crutches occupy both hands. You can't do much stuff without hands! I have figured out how to grip my crutches with my armpit and swing them around (one at a time) to move along which allows one hand to be free but this is a fairly dangerous practice! I few times I've knocked myself off balance while doing this. I've always recovered okay so far but I have nightmares about smashing my head into the granite counter top on my way down!

My physio is going well and doing exercises and icing 3x per day forces me to take breaks from working. I don't look forward to the exercises but always feel proud of myself when they are over because I really work hard at them. Today, my physiotherapist said he will get me on the bike next time! This is something I really look forward to.

In spite of all these positive things and the people who visit and the help I get from my wonderful family and the progress I'm making, I still have down times when I feel, quite honestly, sadness and despair. At first, I blamed the pain meds but those have been out of my system for a long time. I get mad at myself for feeling this way because everything is going so well and so many people are so much worse off than I am ... but the feeling just comes sometimes and I can't always push it away. And then I found this person's blog post called "The Mental Side of Recovering from Ankle Surgery" and that made me feel better about feeling down. She pretty much sums things up for me. I am (was) a very active person (swimming, yoga, walking a lot) and now I do pretty much nothing. I know it's cold out but I really miss being outside! I'm hoping when I can get back into the pool, I'll start even feeling better (count down: 13 days!)

New Phase: Physio

I've been through a fair amount of physio in the past several years for my ankle, my shoulder and my back. It hurts but always feels good after and I've always felt good about going (enjoyed it, even). But this time I was really scared. I have a sense that my post-surgery ankle is much more fragile than my pre-surgery injured ankle. As a result, I was really worried about what would happen at physio. I was tense and it hurt and I had to do deep breathing to get past the pain (which I think now, in hind sight, was really more fear than pain).

Physio consists of the following steps: 1. ultrasound to reduce swelling and other stuff. The metal thing that rubs on my foot feels quite uncomfortable where my foot is still numb (it will take several weeks for the nerve to repair). 2. After ultrasound, I get fitted with TENS pads that connect to a machine that stimulates the foot to reduce pain, apparently. They put ice on top and then turn up the machine as far as I can tolerate (I’ve had this before on my ankle, shoulder, and back!). 3. Then the physio therapist massages the muscles (what’s left of them -- I've had muscle wastage!) in my lower leg and moves my foot forward, backward, left right, around holding each time and pushing much beyond where it wants to go. This hurts.

I have a series of exercises to do at home 3x per day.

That said, I really like the physio therapist and the place I'm going (thank you, Pearl, for recommending it) but after my first appointment, I felt down and discouraged. The next day, I did all my exercises but still felt down (almost inexplicably so). Today, I went to physio again and saw a huge improvement (mostly in my attitude!) but also in my range of motion and how much more easily I can manage the work they do on my foot. So, I'm feeling very positive about things right now and looking forward to each of my physio appointments!

Progress

Now that I have the air cast, I feel more comfortable moving around. When it swells, I can take some of the air out of my cast to relieve the pressure. Yesterday, my sister, Sue, took me shopping. I bought stuff to make a delicious soup and a ready-made salad and a loaf of fresh bread. I came home and sat at the table and chopped vegetables and instructed Hazel on what to do with the ingredients. Together we made soup! It felt good to be cooking again!

I take my foot out of the cast 4-5 times per day and move my foot back and forth. Last night it was quite swollen after all my activity. Even this morning (Sunday), it was still swollen ... more so than Friday. I had another long soak in the bath and scrubbed my foot. It is interesting how much skin is peeling off (yuck).

I find I have to deflate / inflate the cast frequently to get the right amount of stability without discomfort. I'm guessing I'll get used to it soon and will get better at knowing how much is needed either way.

So, I think I'm making progress. I am looking forward to starting physio therapy next week!