Me and My Trimalleolar: Talus All About It

August 28, 2011
1 month 25 days post T-Day

walking boot

Oy.

Pain hurts.

Dear Gods and Goddesses of the Universe,

Thank you for my wake-up call.  Now may I get my foot back?  What if I promise to slow down my life and be more present? 

Love,

Kenda

Footloose and Fancy Free?

On August 17, I was given permission to sleep without Betty aka the Boot.  Imagine my delight!  I felt the freedom of this news instantaneously.  After the surgeon’s follow-up, we came home and Betty was off like Brandi Chastain’s shirt.  My foot felt loose and fancy free.   Scott removed the bandages on the right side (my Tibia incision).  A few dabs of peroxide helped to dry up the grossly oozing pus.  It was weepy (this is a medical term).  I kept the bandages on the left side.  Somehow I was unable to manage dealing with the two wounds at once – keeping one clean, dry and unirritated (is that a word?) was about all my psyche could handle.

As bedtime neared, I grew increasingly anxious unaware of the source of this agitation.  Got myself ready for bed.  Scott helped to load me in there and then he departed.  There I was.  Me and My Trimalleolar…just lookin’ at each other.  I felt so fragile.  Vulnerable.  The various parts of myself engaged in a ridiculous conversation.

Irrational Self:  What if I sleep walk?

Semi-Rational Self:  It will hurt.

Irrational Self:  I’ll rebreak it!  I cannot and will not go through this ordeal again!

Semi-Rational Self:  You can handle the pain.  You are one with the pain.

Rational Self:  Whoa.  Hold on there a minute cowgirls.  Yeah. Um.  Okay.  When again was the last time you walked in your sleep?  That was like…forever ago.  You can release your self of that ridonculous worry.  Now go to sleep.

Irrational Self:  What if I roll over on it and it breaks again?

Semi-Rational Self:  It will hurt.

Irrational Self:  I cannot and will not go through this pain again!

Semi-Rational Self:  Then don’t roll over on it.

Irrational Self:  But how will I know if I’m doing it?  I mean, I’ll be sleeping!

Semi-Rational Self:  uh.  I dunno.

Irrational Self:  YOU are no help at all!

Semi-Rational Self:  Sometimes I think you don’t want any help.

Irrational Self:  That is SO not fair.  I do want help!  I want peace and freedom from pain!

Rational Self:  If this is truly the case, then stop creating thoughts that are giving you pain. You claim to want the freedom from it, yet the very thoughts that you believe will protect you from future pain are causing you harm right now this very minute.   I look at it like this:  either way you’re giving yourself pain.   Here’s what I suggest.  Tell yourself you will be okay no matter what happens.  What’s the worst thing that can happen?  You can fall out of bed.  Highly unlikely.  You can sleep walk.  Highly unlikely.  You can roll over and rebreak it.  Highly unlikely.  Enough of this insanity already and go to sleep!  sheesh!

I spent the night in a semi-conscious state.  Twice I started to dose off, and my ankle jerked.  I awoke startled.   At one point, I gave myself a fabulous full body stretch – the first since this Trimalleolar ordeal began.  Something popped in my left ankle.  Freaked me out.  I spent several minutes inspecting the foot to look for bruising and swelling.  Irrational Self was in control, “Damn!  You broke the screw!  Now you’re stuck with it F*O*R*E*V*E*R!  A broken screw in your ankle!” ugh.

I am to “walk” on it (using crutches and only bearing 25-50% weight), yet my dorsiflexion is awful.  It doesn’t look like a real walk at all.  The pain is sometimes unbearable – to the point of feeling nauseated.  Still, I force myself everyday to work it and to push through it.  I am in a truly ‘no pain no gain’ situation here.  It seems that with each step of progress, I am faced with a new series of issues.  I can now sleep without my boot.  While the freedom of that was immense, little did I know how the fear would grip me.  It took me a few days to relax into the idea and not worry about damaging myself during the night.  It’s all a process, and surely this thing is making me stronger.   I can hear my Dad now, “It’ll build some character”.I’m so aware that with each new and hopeful stage of this healing journey, there arises a new set of issues to tackle.

Now, 11 days later, I can surely say that I’ve had many good nights of sleep.  As in, a full six, seven and even eight (last night!) hours.  I think three things have contributed to this:

  • I am no longer a psycho maniac about hurting myself, and am even surprised I’m the same person at night.  I mean, bedtime was a total bummer.  For a few nights now, I’ve been HAPPY and even EAGER to go to bed!
  • I’ve had three FSM “trauma” sessions that have helped me relieve myself of the psycho mania.  I’m a woman anew!  A women renewed!
  • My darlin’ friend, Elaine, sent me a lovely care package of natural sleeping aids.  I tried a number of natural aids like Tryptophan, 5HTP, and calming tea – nada nothing zip.  But now I spray my sleep essence oils over my pillow and head…and away I go!

Dream a Little Dream

And oh the dreams.  For now, I’m no longer in danger’s way during my REM.  I’ve had many nightmares comprising of the most popular natural disasters.  You name it, floods, fire, erupting volcanoes, tsunamis, earthquakes, meteors, and even the occasional alien invasion.  With each one I was stuck in bed or in my wheelchair scrambling to get to safety.  I always managed to stay alive even when the big earthquake that knocked me out of bed.  I hugged the floor stretching myself alongside the bed just as the roof caved in.  With dust and rubble all around, I remained in a safe pocket at the bottom of a triangle carved out by the floor, the bed and the roof.

My first walking dream came the night of my first FSM treatment a few weeks back.  I walked into a store on my crutches and came back to the car sans crutches.  I stood at the car and wondered how I was able to walk without assistance or pain.  Standing paralyzed at my car door and unsure of what to do next, I noticed three children approaching the car.  They were on bikes, and I offered them five dollars to go back inside and get my crutches.  One little girl took me up on the deal.  She disappeared returning shortly, crutches in hand.

Mostly, my walking dreams involve my going somewhere to get something. Sometimes I’m escaping bad guys.  With each dream, I kid you not; I get half way to my destination or to safety only to realize I forgot my crutches.  50% of the dreams I don’t know what to do and the other half I figure my way out of the situation.   Just last night, I was in the attic of my old house (the one I grew up in).  I had a bag of clothes packed for some trip.  Rummaging around the attic, I found an old fish tank, filled with water and fish.  Only, the tank wasn’t working.  It was a gas-operated tank.  I fiddled with the mechanism (attached to the wall) to get it pumping again.   I had to save the fish for goodness sakes!  Well, as I was fixing the tank ‘engine’, the gas ignited a loose wire and the darn thing caught on fire!  I called for my Dad (again!  I’ve been doing this a lot lately!) but no answer.  I knew immediately where to go for the extinguisher – the basement.  Down two flights of stairs, opening the basement door, I saw everything my Dad used to keep in that stairwell including the extinguisher.  I clearly remembered all his crap – the yellow raincoat, tools, and Maxwell House Coffee containers.  Grabbing the extinguisher and thinking, “Man he should clean that up” I ran back up to the attic.  Much to my chagrin, the extinguisher was old and had no pin to pull.  This did not stop me from trying to put out the fire, which by this time had spread across the wall.  I shook the extinguisher…shake shake shake and willed it to work.  After the fire was out, I assessed the damage.  Not too bad.

I managed to get the fish tank working again.  The next morning I checked on it, and discovered all of the clothes I packed in a suit case the previous night were now in the tank.  No fish.  The water was very warm, and I knew this was problematic.  I eventually found the fish hiding out in a cool place under one of my dark suits. I was heading downstairs to get some ice for the tank.  By this point, there was a freshly bathed dog with me – a retriever setter mix.  He was a rescue dog that I had forgotten about.  The two of us went downstairs to find my Dad in the kitchen with the husband of a dear friend – chatting over coffee.  I told him about the fire and then realized I had walked around for several hours and had even taken all those stairs without my crutches.  I awoke confused.

Unbearable Weight

On August 18, 2011, I had my first weight bearing PT session.  I asked Meghan many questions about my Syndesmosis Screw.  It must be removed 12 weeks post-op.  If I put too much pressure on it, it could break.  If it breaks, it cannot be removed.  If it cannot be removed, it’s stuck inside my ankle.  Did I mention that?  The surgeon said how plenty of people live with the screw in their ankle and lead normal lives.  I know I’ve mentioned this before, and I’ll say it again.  I do not want that screw to break.  But preventing this from happening is not that black and white.  I can put pressure on my foot, but not too much or too often.  I really really wish someone would hand me instructions for this thing.  I think they would look something like:

For the next seven weeks you must:

  • Not freak out wondering if you’re going to break your screw.
  • Build up to 75% weight on your left ankle by gradually increasing the weight every two weeks.
  • Walk on your crutches eight times a day equally dispersing your weight among your four largest limbs.
  • Remain calm (aka not freak out – reframed) and trust the screw will NOT break.  You may have a loose screw by your surgery date, but it will not break.

I overcame another hurdle on August 21.  Scott and I drove to the city to celebrate my friend, Colleen, and her new book, The 30-Day Vegan Challenge.  Yes, I was nervous about the long drive and my car comfort factor.  Yes, I was worried about having to park far away from the venue (the Millennium – one of the yummiest restaurants in SF).  Yes, I was wondering about getting caught in a mosh and having my foot knocked around.  But I womaned up and went.  Outside of a very achy foot by the end of the journey, everything went swimmingly well.   Scott tells me I have to stop worrying so much, because I’m wasting precious energy.  He’s right!  He’s right!  I have no problem admitting that, I only worry about being wrong!  JK!

Bye Bye Betty, Hello Hiking Boots

Tuesday, August 23, 2011

A monumental day for a number of reasons:

  • I can now wear hiking boots to PT.  That makes riding the bike a whole lot easier.
  • I turned in the wheelchair (after a cruise through Costco to load up on their organic berries for our Vega smoothies).  No more reliance on the chair, which could make me a very lazy person b/c it’s easier to wheel than crutch.
  • I drove back (by myself with Scott in the car) from returning the wheelchair.  It wasn’t as scary as I had imagined…driving.
  • I had a new PT (Meghan’s on vaca).  He’s the owner of the facility, Eric, and he informed me that my Talus won’t budge.

Whaaa?

YelpMy Talus won’t move!

THAT explains the reason my dorsiflexion – hell all my flexion – is so bad AND the pain!   Man, he worked it.  I would’ve cried had I not been so fascinated, curious, and confused over the matter.  How is it possible my Talus won’t move?  For anyone who knows about the Talus, it’s actually a very important component of the ankle.  It is the ONE thing that connects my leg to my ankle and that helps the ankle move.

Naturally, I asked a gazillion questions including:

  • Tell me again, what does the Talus do?
  • Is it possible the surgeon messed up and didn’t realign my bones correctly?
  • Do you think she forgot to put it back in its proper place after reducing my Tibia and Fibula?
  • Is there something permanently wrong with me?
  • Have you seen this before?
  • What was the outcome?
  • Have you ever seen a situation in which a person’s Talus is stuck forever?
  • Do I need to see a chiropractor to get it moving?
  • Would drinking more water help?
  • What do I have to do to fix this?
  • How long can I expect it to be like this?
  • Who am I?
  • How did I get here?

He surmises that the internal swelling and scar tissue are blocking my Talus’s ability to function properly.  Somethin’ somethin’ inflammation cartilage.  He wants me to really push it, as in, practice the weight bearing more often, dig in there with my thumbs to break up the scar tissue, and walk on my crutches as often as possible.  Heel to toe.

The next day despite the aftermath (pain and swelling mostly) of a very hard PT session, I followed his directions.

O*M*G.  The pain.  Unbearable.  Unbelievable.

Barfable.  My foot swelled and turned eggplant purple. It actually looked like an eggplant.  Even Scott was shocked enough to tell me to call the doctor.  I didn’t.  Some elevation and wishful thinking brought it back to normal.  I began questioning my ability to heal through this injury tho.  My motivation plummeted.  I mean, how motivated would you be to practice ‘healing’ when all you received was a painful smack down?  There was no reward and only punishment.  Once again, I was confronted with the hard facts.  A Trimalleolar Fracture was no walk in the park, but if I ever again wanted to walk in a park, I must push through it.  I must be one with the pain.  My mantra, It’s all in my head.  I am walking. I am walking.  I am walkingJust put one foot in front of the other

I persevered.  Thanks to Santa Claus and Rudolph.

Today, August 28, 2011,

Showered, semi-shaved, and happy.  I am much more comfortable with my ankle.  I worry very little about my damaging it and no longer feel the need to handle it as gingerly as I had previously.  I can crutch around my house with only about 50% of the pain I had less than a week ago.  While my left leg still locks up and my knee pops, I am liberated from the excruciating pain.  I am faithfully doing my PT exercises two-three times a day in addition to whenever I think about it (which is often), and pushing pushing pushing through that pain.  Boo on you pain. You’re not even real.

Physical Therapy Kickin’ Butt

  • Stretches (using theraband and a robe tie) for both feet:  three sets of 30 pulling up, pushing back, and pulling side to side
  • Big circles 20 times both directions both feet
  • Toe wiggles
  • Spelling out the alphabet (I switch back and forth between regular and fancy writing and printing) both feet
  • Sitting down, I place both of my feet on the ground and try try try to get my left leg at a 90 degree angle (neutral position) slowing pulling to increase the dorsiflexion.  VERY hard to do!
  • Calf raises using my toes only (sitting and standing)
  • Calf stretches
  • Weight shifts (side to side and front to back)
  • Try to bunch up the towel with my toes (unsuccessful so far)
  • Roll a ball under my arch.
  • Hip openers (all four sides)
  • Leg lifts
  • Wall walking
  • Sideways Feet lifts (trying to build strength in my left ankle)
  • Achilles Stretches
  • Crutching crutching crutching with a strict focus on not limping by following through with the crutches and a stricter focus on heel to toe movements.  I cannot pretend!  It’s so easy to try and trick myself just going through the motions.  I know I’m really doing it when it hurts.
  • Lots of massaging with Calendula ointment to loosen up the extremely tight skin around my Tibia incision.  With each step, the tightness feels like it will tear open especially with the swelling. Turns out gravity and a slowly recovering circulation make for a nasty swelling experience.
  • I Try to keep my foot moving to break up scar tissue.
  • Ice 1-2 times a day

Thar ya go.  I can Talus all about it.

Just put one foot in front of the other…

Here’s a shout out to all my east coast friends and family – hope y’all are safe from the wrath of Irene.

To see all the  posts in the trimalleolar series, click away!  Things DO get better!

Post #1 Me and My Trimalleolar:  A Life-Changing Tripulation
Post #2 Me and My Trimalleolar:  Transcending the Funk
Post #3 Me and My Trimalleolar:  Tiny Bubbles of Progress
Post #4 Me and My Trimalleolar:  A Healing Ankle
This is Post #5 Me and My Trimalleolar:  Talus All About It
Post #6 Me and My Trimalleolar:  A Week of Firsts
Post #7 Me and My Trimalleolar:  Cast of Characters
Post #8 Me and My Trimalleolar:  9 1/2 weeks…
Post #9 Me and My Trimalleolar:  The Screw, Some Scars, and a Busted Uvula
Post #10  Me and M Trimalleolar:  Walk a Mile in My Screws
Post #11 Me and My Trimalleolar:  11 Months and Moving Right Along
Post #12:  Me and My Trimalleolar Go to Mexico…with my husband and our pooch

15 Comments:

  1. Pingback: Me and My Trimalleolar: A Week of Firsts Travels and Tripulations

  2. Pingback: Me and My Trimalleolar Go to Mexico…with my husband and our pooch - Travels and Tripulations

  3. Pingback: Me and My Trimalleolar: A Life-Changing Tripulation - Travels and Tripulations

  4. Pingback: Me and My Trimalleolar: Cast of Characters - Travels and Tripulations

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  6. WOW! I have submerged myself in research about trimalleolar fracture since I slipped on a *tiny* patch of dewy grass Mar. 21 while vacationing in Texas. I can well relate to your extra difficulty navigating with a badly broken ankle plus a bad sprain on the other leg, since I managed to tear the meniscus on the non-fracture side, in my twisting fall. Thankfully I didn’t injure the ankle ligament and don’t have that extra complication in recovery and therapy, or another surgery to remove the extra screw. There is so much science out there about these fractures, the surgery, the therapy, but my great delight in reading your piece is that it goes inside the subject to what this is like to experience this process over quite a span of time. And I can see that adherence to exercise and therapy routines, within safe limits, hastens the recovery, as does staying positive and keeping a sense of humor. Thank you for sharing – there is much I can relate to.

    • Hello Bev and welcome to the blog! I’m sorry for the circumstances that brought you here, yet am glad you found us.

      So many of us arrived at this place from what some would call a “simple slip.” We know all too well there’s nothing simple about this injury!

      And a meniscus tear? Ay yi yi. I hope that heals quickly so you can bear weight on the other leg. You didn’t tear the ligament, so you definitely have that in your favor. I have a sense you’ll be bearing weight in a shorter time (once you get that meniscus business cleared up).

      From my perch, I see good healing in your future. I’m delighted that there are some things in this blog you can relate to. And I totally agree and support you on adhering to the PT’s advice and keeping that sense of humor whenever you can. I say this fully realizing there will be some moments that are not at all funny right now but may seem lighter when you look back on them in the future. 🙂

      Please come back and share your progress when you feel like it. These posts get a lot of hits, daily, and I know there are people, just like us, who want to know they will come out on the other side of this in a good way. And I believe you will – you’re already over a month in. I think the first 3 weeks are the hardest, so you may start to notice real progress with each passing week.

      Thanks for writing in and cheers to your healing,
      Kenda

  7. Hi, Kendra, still learning as I go here. Just as the doctor told me to expect, I was *very stiff* when I got the cast off, and very adept PTs have helped loosen up what felt like a concrete block at the end of my leg. I am fully weight bearing and about to start the weaning process from the boot (4 weeks after cast removal). One of the mysteries of this adventure is why my right knee has hurt soooooo much, compared to the trimalleolar fracture on the left. Ah, thanks to the magic of MRI, now we find out that in addition to the torn meniscus, my original, fantastic, twisting maneuver also caused bone bruising on the right knee: the busted ankle didn’t “hurt” all that much because it was immobilized; the right knee was anguishing at every move because it was injured and not immobilized. Nevertheless, I am moving ahead and so thankful to have a malady that I WILL recover from! Hope you are doing well. I join many others in thankfulness to your encouragement to fellow trimalleolar patients. Thanks, Bev.

    • Welcome back, Bev! So good to hear from you again.
      Oh me oh my oh me. Bone bruising on the opposite knee in addition to the torn meniscus. Your plot thickens. I read the word “anguish” and can practically feel your pain. I hope now with that diagnosis your doc has a plan to help put you on the mend. The good news is that you have adept PT’s who are helping loosen that concrete block around your ankle (I remember that oh too well).

      It does sound, however, that your spirits are high, your statement “…so thankful to have a malady that I WILL recover from!” is spot on and inspiring for us all. Thank you for that reminder, especially for others who are just beginning this journey.

      Thanks for your kind words, too, I appreciate it.

      Cheers to you and your healing! If you feel like it again (no pressure ever!) updates are always welcomed and appreciated!

      Kenda

  8. My apologies, mis-spelled your name above. Very sorry.

  9. Hi Kenda, I’m new to the trimalleolar club. I broke my left ankle on 6/28/17. I was simply getting off my bike, and lost my balance when I stepped on a piece of garden edging rather than the sidewalk. It’s amazing how little it takes to suffer a pretty devastating injury. At least I have one uninjured leg though and two healthy upper extremities! It could be sooo much worse. My heart goes out to you having to deal with both Lower extremities being out of commission at the same time! The silver lining for me is an outpouring of love and support from friends and people from work. I am now 2weeks post surgery (I was lucky they got me in 14 hours after my injury). I am NWB for 6 weeks. I can get my incision wet and I can take the boot off several times a day to do AROM exercises. I am noticing sensory changes in that foot and leg, but I guess nerve damage is pretty much inevitable with such a severe injury. It is reassessing to read your blog and learn that this is normal and normal sensation will return eventually. I am trying hard to focus on blessings and small joys. I was already taking antidepressants before this happened, and I do think that has helped me cope. Plus I have a super loving and supportive husband who works from home. I’m an occupational therapist so I have some background in rehab. I’m good at figuring out how to accomplish most ADL and simple household tasks.

    • Hello Cathy,

      Welcome to the Trimal Club. Sorry you’re here but glad you came, if that makes any sense!

      My OS and PT both told me that it’s often the simplest actions that cause the serious injuries. I’m glad to see you have one good leg to support this healing journey and hooray for the outpouring of love and support! Really, when I’m looking over your message, things have lined up really well. You were able to get surgery right away, you have support, you’re only NWB for 6 weeks (it may not seem like it now, but that time will move along), you can get your incision wet and take off your boot (that’s SO awesome), and you have a super loving and supportive husband, AND you’re already well-trained in the area of healing as an occupational therapist. To me, it seems like the perfect set-up for a speedy recovery. And I think the antidepressants will help. I think I had my first bout of clinical depression after that injury. Fortunately it was short-lived, but no doubt the emotional duress and pain is a real thing.

      Yes, the nerve damage is normal. I still have some small spots on my foot that are numbish, and I’ve also noticed some areas where the sensation returned (I mean, like years later) where I thought it was gone for good. I guess our bodies really do want to heal. The sensation came fully back to my leg and rather quickly. Thankfully, because shaving was super weird when it was numb.

      If you figure out some cool hacks for managing household or work tasks, please share. I’m certain others can benefit. These posts get hundreds of weekly hits. While not everyone is writing in, there are a lot of readers out there.

      Thanks for writing in.

      Keep on healing on!

  10. I appreciated reading Cathy’s entry and Kenda’s encouraging response. I “joined” the Tri Club on March 21, 2016, then found I had wrecked my right knee while fracturing the left ankle. What was so totally all-consuming for months of 2 surgeries, recovery, pain, PT, etc. is mellowing as I’m thankfully able to take back more and more of my life as an active senior. The hardest part was being patient and letting healing happen at its pace. Sixteen months later, I can walk 2 miles in 36 minutes without exhaustion or pain. Blessings from Tuscaloosa! Bev

    • It’s so nice to hear from you again, Bev. Thank you for following-up!

      Looks like you’ve come a long way not only with the ankle but with the knee. Your words of wisdom are noted: be patient and let healing happen at its pace. Thank you for that.

      You are doing great. After all of that, it must feel like a major accomplishment to walk the 2 miles in 35 mins! Well done!

      Maybe one day, you’ll stop back in to share more of your successes?

      Cheers to you and your healing,

      Kenda

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