Tuesday, December 14, 2010

2 years after breaking my ankle & surgery

Two years after my injury & repair this is the real story. It is true that my left ankle does not feel the same as my right ankle. It is slightly stiff, especially if I don't stretch everyday. I have learned that working out each week with weights doing squats & lots of jumping on my bad ankle does help. It's not pleasant & I suppose I wish that I had done this earlier; but you really have to work the ankle to make it hurt less & be more flexible. I have patients who have not worked their injured ankle (or other extremity) & find it to be frozen & stiff. If there is one thing that I can offer to you, who have unfortunately suffered such an injury, is that you have to step it up a notch & really work it to make it less stiff & perhaps, prevent arthritis. I skied Jay Peak last weekend & felt really good - I actually felt that my left (injured) leg was stronger than my other (right) leg. Recover depends on so many things - PT, massage, acupuncture, laser, basically working your ankle like the other one. But when you feel stronger, you have to add weights & so some strength training - not to be an athlete, but to feel less stiff & stronger.

Monday, January 4, 2010

Sticking to the Groomers!

I've spent the last 2 weeks skiing & must say that it feels OK. I didn't get new boots or liners - just let the warmth of my foot "re-mold" them. New boots may be a consideration for later because I did notice my left boot was pretty hatched up from last year's accident. Still have the same K2 Schi Devil skis & 7TM bindings. But I am being conservative in my skiing & I am sticking to the groomed trails, resisting going into the trees; hiking up & skiing backcountry. I must say that in skiing from hardpack or ice to clumps of snow (man made or natural) or vs., I notice the "jar" more on my left foot. That is, it doesn't adjust as quickly as the right. But my legs are under me & I feel balanced. I keep working on my ankle - doing the exercises, yoga, stretching. My New Year's resolution is to get more plantar flexion. For all my readers out there that have had a similar misfortune to have broken your foot or ankle - stay strong mentally & physically, develop a home PT, & don't fall victim to those who say "You probably will have arthritis & not be able to do the things you used to do..."

Tuesday, December 15, 2009

One Year Anniversary ORIF

It was one year ago, today, that I had my initial surgery for my ankle fracture. I remember the pain and because of that, I have learned a lot about pain. For instance, any pain that occurs prior to surgery (i.e., the type of pain that typically occurs after a fracture while one is waiting for surgery) will contribute to postop pain & increase the chances for chronic pain or at least the difficulty in controlling acute pain post repair. I have also learned that any patient that has acute pain postop that is not adequately controlled will have a greater than 50% chance of developing chronic pain afterwards. I would have to say that I was on track for that end - except for my knowledge of alternative ways of treating pain - such as acupuncture, laser biotherapy, topical herbs, importance of stretching, PT, etc. I am grateful for that knowledge & for the expert practitioners that treated me. The other thing that I have learned is that the ancient TCM statement of "where there is movement, there is no pain & where there is no movement, there is pain" is correct. Being stiff, resisting movement (PT, exercising, stretching even if it requires pain meds to allow for it) is bad & leads to more pain. Even now, one year later, I still do my exercise routine to reinforce/remind my muscles, ligaments, tendons that they have to be engaged in walking, moving - that there is no day off. THANK YOU to Dr. Mark Klion (my surgeon), Dr. Meg Rosenblatt (my anesthesiologist), Tammy Day (massage therapist & acupuncturist), Karen (PT) & all my friends & family (my husband - Michael - who continues to help me & my children, Sam & Mary Ann) for their support! I cannot imagine getting through this without all of them.

Monday, July 27, 2009

Hardware Out & Feeling Good

Finally, my surgeon, Dr. Mark Klion, took the plates & screws all out of my ankle!! I wasn't sure that he could remove everything, but he did. He said that my plate would have really bothered me in my ski boot. The surgery went well & thankfully, the postop pain was not too bad. Many thanks to Dr. Meg Rosenblatt for giving me such a long-acting great nerve block! I feel that I have become an expert with respect to postop fracture surgery pain. Judicious use of narcotics and guided imagery while immobilized really helped. And this time I could start moving my ankle within a week after surgery - preventing stagnation really helps to prevent pain. But this type of surgery - removing hardware - is not without risks. There is an increased risk of re-fracturing the bone because when the plates & screws are removed, they leave openings or holes in the bone. Until those holes are filled in (takes 4-6 weeks or more), any twist or sprain could cause another fracture because of the weakness in the bone. What that means for me is no hiking, biking, yoga inversions, basically nothing where I might land badly on my ankle & twist it. Walking has become a cautious activity for me! But it is well worth the trouble because I no longer feel sharp pain when plantar flexing (pointing my toes) & my swelling has gone down since there is no more irritation. But my ankle is stiff & I am cautiously doing isometric exercises to improve range of motion. Hopefully, in another few weeks, my X-Ray will show that my bones (tibia & fibula) have filled in & I can start really exercising. THANK YOU DR KLION!! The scars are really not too bad either!

Sunday, June 14, 2009

Six Months Postop & Still Stiff

A little more than 6 months after surgery (ORIF) for my broken ankle & I still feel a leather grip type sensation when I move it. Doctor says it's because of my foot's reaction to the surgery & trauma. Otherwise, my ankle has "healed great" from the surgery. I get the screws taken out in 2 weeks & I have to believe that I will feel better after that. At least wearing shoes should feel better! My RSD type feeling with electrical sensations & skin discoloration has gone, with laser treatments & lots of exercise & activity. I continue to do yoga, bike, hike, kayak, drive my stick shift car, & now added spinning classes - all of which force me to move my ankle past comfort.
But still, I had expected more by now. And it is easy to get depressed about not having full movement & to always be thinking about the ankle. I will welcome that day when I actually forget about it & can't tell which ankle was the broken one! All I can say is how impressed I am with how much time is involved in healing & with the body's extensive reaction to injury. I have learned a lot!

Sunday, April 12, 2009

Different types of acupuncture for RSD/CRPS

I was fortunate to attend the recent AAMA meeting in Fort Worth, TX; where I received 3 different acupuncture treatments for my ankle & early reflex sympathetic dystrophy (RSD), aka complex regional pain syndrome (CRPS). First I had a muscle channel technique given by Dr. Frank He & left the needle in for 2 days. Then I had Collateral Meridian Therapy with Dr. Shang Ko, which does not involve needles or pressure on the injured area. By now my electric type pain was lessened, but not completely gone. Lastly, I had laser acupuncture by Dr. Michael Weber, using the new weber needle device allowing for 12 acupuncture points to be treated simultaneously with up to 4 different wavelengths. Because the laser needle doesn't penetrate the skin, it is painless. It has been a week since all of these treatments & my pain is completely gone. My ankle is more flexible & stronger. I can now go down steps without hopping! Perhaps there is something to all this acupuncture!!

Herbal remedy for postop pain

I want to put in a thumbs up for Chi Herbal Muscle and Joint kit - part of the Chi Formula natural product line that I use for my face patients. You take a hunk of the herb ball & form it to conform to the area of where your pain or stiffness is - for me, it is the lateral, medial & dorsal surface of my ankle. You wrap a 4X4 gauze or other kind of wrap around it (other kind of gauze, kleenex, cast sleeve) & then loosely put an ace wrap around the entire area to keep it all in place. I keep it on all night, sleep with it & don't need to take a tylenol for sleep. In the morning, take it off with the gauze & you will see that the swelling is much decreased & it even stays down throughout the day. I find that I can really exercise my foot harder & get more flexion out of it in the morning after using the herbal wrap. It is a good adjunct to the PT, acupuncture, stretching, yoga, etc. that I am already doing. More about acupuncture later...