Me and My Trimalleolar: Transcending the Funk

The following post accounts for July 25 – August 7.  I’ve been keeping a journal, and this post shares most of what I’ve been writing…not all of it.  Some stuff feels too ____ (fill in the blank…private, vulnerable, personal, delicate…).  If you’d like to see the first post of my saga, click here. 

July 25, 2011

Add insult to injury, I had a dentist appt. scheduled today.  My dentist told me that because I have hardware in my legs, I now have to take antibiotics before my appointments – at least for the next couple of years.  This is due to their cleaning my mouth, which disturbs the bacteria in my mouth (GAWD.  Even my microbes are disturbed!) that could then run amok through my blood looking for a new home.  Apparently the screws in my leg make for a nice microbe love nest.  I had to take 4 pills and wait 20 minutes before they would take me ‘back’.  I am anti-antibiotics.  Just another reason to remove this hardware when I can.  I later discovered that my OS doesn’t believe it’s necessary to take the meds for my particular situation.  So I took a prescription for nothing.  Harrumph.

On July 26, 2011 (23 days after TF Day) I began Physical Therapy.

My new PT is Megan, and she seems to know her stuff.  Thank goodness.  She told me, If I had a nickel for every person who came in here with a broken bone or a torn ligament for doing something very ordinary like walking or standing up, I would be rich.  We took the broken ankle out of the boot.  It intimidates me.  It looks so fragile.  I feel vulnerable with it.  Like a newborn.  I touch it gingerly for fear of hurting it.  I am fully aware that fear is in charge right now, and I want to give courage back her voice.  I asked Megan questions like:  Well, if it’s broken and not all the pieces are attached by plates or screws, could it fall apart when it’s outside of the boot?

I really had no idea that I could work on moving my ankle and toes just two weeks post-surgery.  She held my foot in her hand and gently flexed it back until I asked her to stop, and I was at a 9-degree from neutral angle, which apparently is pretty good.  I have another 15 degrees to go in that one direction (past neutral pointing my toes back) and about 65 degrees in the other.  She showed me some exercises to strengthen the right ankle so that I can begin to use that with a walker or crutches or a scooter.  My treatment program includes icing both ankles 3 times a day and giving myself PT to both ankles 3 times a day using a ‘theraband’ and practicing toe bends (pointing my toes as far as they can go), flexing in different directions and making circles.  She massaged my foot in an effort to begin breaking down scar tissue and then put some stimulator thingys on different parts of my leg and icepacks all around my foot and leg.  It felt quite good.

July 27, 2011

I am in a funky funk funk.  I thought I was doing okay, but it hit me again, and I sunk to a very low place.  I’m trying to be optimistic and real.  Sometimes those two things simply don’t coexist.  After researching about the negative consequences (umm…liver damage and renal failure anyone?) of acetaminophen, I stopped taking pain meds, which might be part of the problem.  I speculate the pain meds numb everything, and all the pain meds have acetaminophen.   The pain is not horrible and certainly, to me, the alleviation of the pain is not worth the prospect of gaining other physical ailments.   One study showed how individuals that take 105 – 360 acetaminophen tablets (500mg) in a year’s time increase the risk of liver damage by 40%.  I calculated that as of July 27, I had consumed the equivalent of about 120 tablets.

Scott suggested I discontinue reading the blogs and forums online about other people who have had Trimalleolar Fractures.  They are, for the most part, discouraging.  Both he and our friend, Julie, mentioned that most people do not return to the forum or their blog to share the good news.  Most people remain online to receive support for their issues.  This leaves a large demographic of Trimalleolar Fracture people living joyfully in the world.  I will return with the good news when this is all over.  Hopefully I can provide optimism to someone else in the future who may be struggling like I am now.

July 28, 2011

It was such a hard night last night.  I broke down again.  That was twice yesterday.  I am in total grief mode thinking about the days that led up to my injury and how I wish I could do it all over with changing just that one decision to go to that spot for sunset.  I’m wishing the universe had given me a less-challenging wakeup call.  I really really do believe there is a reason for all things, and I still haven’t found out what it is.  My Dad would’ve called this crisis a ‘character building’ opportunity.  Sheesh.  How much character does one person need already?  I’m traumatized here!

Clearly I have signs of depression.  I’m classic DSMV except that it doesn’t last all day long, and there is a direct cause – a medical condition.  But otherwise, I certainly have five or more of the DSMV symptoms present during the same 2-week period and they certainly represent a change from previous functioning.

  • depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
  • markedly
  • significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
  • insomnia or hypersomnia nearly every day
  • fatigue or loss of energy nearly every day
  • diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

OY.

Last night Scott and Stella were trying to comfort me.  I was sobbing.  I mean sobbing.  You know the kind…gasping, gulping, uncontrollable tears, a river of snot, the inability to get a grip. Scott was holding my shoulders, and Stella was licking my hand.

This is so unfair, said I.  I deserve better.  I’ve worked so hard and deserve a reprieve without pain!  I told Scott, You deserve to be unburdened during this downtime before you have to go back to work.  We deserve to take that vacation we were going to take in September!  I now won’t be able to have my book release party in August.  I’m reading online how people, even after 18-24 months are still struggling with pain and swelling.  They are still unable to do what they could do before their injuries.  Why did this have to happen to us?   Waa waa waa.

Later that night, lying there in the dark, I heard myself and the negative thoughts.  Then I heard myself say, Why can’t I have a BREAK!

I laughed out loud inside my head.

The losses.They grip me with sadness. This morning I took off my boot to do physical therapy, and I was looking at both my legs and feet.  My left leg has atrophied so badly.  It’s starting to look the leg of a malnourished person – not quite a famine victim – but pretty bad relatively speaking.  I stared in despair at my deformed left foot with all the funky colors, dried blood beneath neatly placed band-aid thingys, and the involuntary lean it has to the right.  When I place both my feet together, the left is clearly at a different angle.  Does that correct itself when I strengthen those muscles?  I tried to flex my calf muscle.  Nothing.  I tried and tried.  Nothing. Then.  I closed my eyes and relaxed my body and told myself to focus only on the calf muscle.  I pulled back focusing focusing focusing and am certain I felt a little movement in my calf.  A fleeting dash of hope.

I thought about a comment Scott made only two days before TF Day.  We were watching sunset.  I was in flipflops, and he said to me, You have such cute feet honey.  I now look at this mangled thing called a foot and think, take me back to that moment, so I can just be with it and really embrace it and really appreciate it.  Just take me back to that moment when everything in the world seemed okay, and I found myself very content with my life.  That lovely moment.

I hear seagulls from my office window and sometimes from the bedroom.  I don’t see them, yet I know they’re out there.  Soaring high above the waves.  There was a seagull Scott and I saw several times during the months of May and June.  He had one foot that was bent out to the left and couldn’t stand on it.  He would fly by us and land on his one good foot.  We called him Gimpy Gull.  I am gimpy gull.  The other night, I lay there staring at what used to be my left foot.  I allowed myself to feel it free of pain meds and can only describe the sensation and discomfort as a fireworks finale beneath my skin.  It went on for hours, and I lay there feeling and watching.

Gimpy Gull flew despite his handicap.

Emerging from the Funk

Now I am fully aware that I cannot rely on external factors to bring about contentment, because there’s little accountability until I can find it within myself.  Find it within myself regardless of everything else.  Regardless of anything else.  I need to reach deep down within myself and find that contentment.  Peace.  My misplaced joy for life, for being, for believing that I am okay despite my current situation.  That I will be okay regardless of the outcome.  And while I had great excitement about my book release party in August, a month-long vacation driving up the coast to Vancouver in September, the prospect of cool gigs, school readings, and speaking at a National Leadership Conference this Fall, I have to find a way to release myself of those plans, cut my losses, and focus on healing.

Physical Therapy…must say it’s pretty cool and gives me a sense of empowerment, even excitement.  Like I have a little bit of control over this situation and certainly of the outcome.  It also kicks my butt.  I’ve had two sessions and was in some crazy pain after the second one.  It slowly diminished.  My ankle feels like cement has been poured around it (kinda what it looks like too) because 1) the immobility locks up the muscles, 2) the muscles were traumatized and injured thus there’s a bunch of scar tissue there getting in the way of the joint and of my moving it, and 3) Swelling

Dedicated to my healing, I worked on the TF ankle for two days between PT sessions and was 4 degrees from neutral improving 5 degrees by my second PT.  That’s hopeful.  But Megan, my PT, said, I cannot expect to get full range of motion until well after weight bearing and even until I begin walking again.  I think I might have been too competitive with myself, because my heel, two days later, still hurt.  Go figure.   I need to remember that this is a process, and a very long one.  I cannot expect to reach the desired outcome NOW even if I want it NOW!  Patience.  A little bit at a time.  One day at a time.

By the second session, Megan put me on the bike.  I need to build strength in my right leg as I prepare for bearing weight on my left.  I could only rest my left ankle against the peddle without bearing any weight on it.  Have you ever tried that?  It requires some concentration.  I used my right ankle to peddle for 5 minutes and at a fairly slow pace.  I was sweating.  She also put me on the wobble board (sitting on a chair not standing), and that really tested my ability to endure the nauseating pain I feel in my plate and screw area.

Today is August 7, and I’m feeling pretty darn good all things considered.  I’ve had some realizations that have lifted me up and are helping me transcend the funk.

Realization #1:  I struggled to recall the moments leading up to the injury, because frankly, all I remember is hearing a weird cracking, popping sound and hitting the ground.  THEN I had a flashback.  I was so busy watching everything going on around me (people at the beach building bonfires, the ocean), that I was not watching my step.  Megan (PT) said, Your brain was telling you one thing (you’re okay, you know what you’re doing), and your body was doing something else.

I saw that as a typical ME moment.  Preoccupied, not paying attention to where I was going, not being present.  My friend, Colleen, gave me a beautiful reframe:  It’s so like you, Kenda, taking in your environment and seeing everything that’s going on around you.

Realization #2:  This one struck me so profoundly.  When I fell, I fell directly on the path.  It’s a narrow path, and my body was not one inch off of it.  Again, Megan said something to the effect of, That’s your body taking care of you.  Essentially, on some level, my body knew that I had to fall a certain way in order to avoid falling over a 15 foot cliff.  And while the manner in which I fell was traumatizing and left me with this horrific situation, had I stumbled even 12 inches to the right, I could’ve tumbled 15 feet down, cracked my skull, broken my back or potentially died on the boulders below.  My sister, Tina, has been telling me, I believe this accident happened because it prevented something worse from happening in the future.  I do believe she is right about that.  I can’t help but smile when I think about how my body saved my life.

So, yes, I am transcending the funk.  I am having good days and have been for over a week.  Sure, everything is an effort, and sure, I have had to adapt my days to accommodate this injury, and yes, menial tasks require great concentration and energy, but I am doing okay.   My favorite parts of the day are when I liberate my foot from the boot.  Oh the joy of fresh air on my skin!

Already, I see noticeable differences.  Swelling is decreasing.  Skin color is returning to a semi-normal state.  I can wiggle my toes (except for the big one which remains obstinate and numb).   PT is giving me strength.  I rode the bike for 10 minutes last session, and the expectation was seven minutes, and they have me on the shuttle lifting off with both legs.  I actually saw a muscle in my left calf!  I can now sleep in up to 4-hour increments with minimal restlessness despite the fact that I can only sleep on my back, in my big boot, elevated on pillows with achy knees.  I do miss rolling over.  That horrific pain I was feeling in my heel is diminishing.  The fireworks under my skin still go off at night, but not with such intensity.  But now that I know the fireworks (the electrical shocks that buzz all around my foot) are my nerves busily working to repair themselves, I welcome them.

Visualizations n’ Other Such Efforts  

Mostly, I do it at night. Visualizing, that is.  I visualize my healing helpers working their magic on my foot. The one healing helper is a ‘glow’.  It’s long and lazy and patient.  It starts at my fingertips and slowly works its way around my entire body stopping at my feet and filling them with light and healing.  The other (and this is one I’ve had for several years) are fairy-like.  They are kind of like a cross between a hummingbird, tinkerbell and a gremlin.  They are teensy tiny, very sweet, and efficient.  Dozens of them inside and outside my body fluttering around and sprinkling sparkling healing dust all over my body.  Last night in bed, I was imagining several of them around my big toe (it’s been essentially numb now for 4 weeks) and (believe this or not!) I began to get a tingle in my toe!

I am using the walker more and the wheelchair less as my right ankle continues to heal.  When I feel really good, I can stand at the sink on my right leg, throw my left leg over the left part of the sink and wash dishes.  I brush my teeth in much the same manner.  I can get myself up to my office via ass-taxi, thump across the room, turn onto my knees lifting my boot up so it doesn’t hit the ground and simultaneously grabbing onto the desk with my free hand and my ‘good’ leg, hoisting myself into the chair.

Every day I lift myself up and continue to move forward.  With each day, the lifting becomes easier as the weight within me becomes lighter.  My neighbor stopped by today with a fistful of gorgeous flowers.  They are bursting with golden brilliance.  My heart smiles looking at them.  I have a desk adorned with cards, regular email check-ins, calls, and facebook messages that remind me of all the good things and beautiful people in my world.

I do believe I am transcending the funk.

 

Left ankle: One week post-op and Right ankle: Still sprained (swelling mostly on the right)

Left ankle: One week post-op and Right ankle: Still sprained (swelling mostly on the right)

Three weeks three days post-op

Three weeks three days post-op

Right side one week post-op

Right side: One week post-op

Right side three weeks three days post op

Right side: Three weeks, three days post-op

One week post-op

Left side: One week post-op

Left side_3 weeks

Left side: Three weeks, three days post-op

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
This is 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
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