Cleared to exercise (kind of)

I guess I might as well get one post in before the craziness of back to school/soccer season starts and my blog posts suffer more than they already are.

Ankle, ankle and more ankle stuff.  I swear my life revolves around it. 

I looked WAY cooler with one foot on the ground and the other pushing this forward.

• Dr said 2-3 more weeks with the boot (I'm writing this at the end of week 2) but I'll tell you I am hurting tonight after just being at work and walking around for about 5 hrs. The last week, I'm supposed to be working towards transitioning into shoes, but honestly, I don't see it.  I'm going from be a couch potato recovery mood for 6 weeks to standing on my feet for 7 plus hours, without a boot?!  I'm going to baby this ankle for at least a week more. 
  
  
   
• Dr said I could start to exercise on the elliptical (hell NO!) and I could start spinning again.(hell YES)  Yay!  Of course, when I hear "Go" I really went for it.  It happens that they are offering spinning classes multiple times a day this week.  Yep, "overdoing it", 5 classes in 3 days.  It felt great to be back but I'm feeling it a bit too.  My ankle didn't hurt while doing it but it was swollen and tender later.  

• I started PT this week.  Sadly, it was like a homecoming of sorts since I have been going there all spring.  My one PT said I should get a personalized parking spot since I'm there so much.  I shouldn't be surprised that I can't do much, but sometimes I really am.  Today, I had to put my foot on this sliding board and just push it forward and backward.  Holy cow, that hurt like crazy.  Pushing my foot back was insanely hard and did I mention it hurt?

• On top of my celebrating my return of sorts to exercising, my FAVORITE brand for workout shirts is having a SALE which they never have.   YMX Yellowman  has the most amazing shirts.  Normally the tees run about $70 but they are on sale for $30.  I have 2 already and have worn them at least once a week for the last year. They wash up amazing, they have fabulous designs and the maxcool fabric feels like silk yet wicking!  I just bought 2 more and a tank.  I can't wait to see what is up next since they are only doing a few items for 3 days then its on to something else for $30.  Here's my review from last year.  YMX shirt review

Obligatory Ankle Scar photos

This is about 4.5 weeks post op

What an "mini open partial excision" scar looks like. Not as mini as I'd hoped. That's about 1.5".

tiny ankle arthroscopy scar

Lazy recovery time

Recovery is hard.  I mean, sitting around all day with your foot up, watching the Tour de France, followed by marathon sessions of Mad Men, True Blood (after the children have gone to bed) and Portlandia is really hard.  Actually, I'm so sick of sitting. Couch, arm chair, in bed.  Ugh, Can I just walk already?  I miss getting up and grabbing a cup of coffee, water, etc.

Buster made my whole lunch, cut the apple and everything!

DH, Buster and Cub have all been so helpful.  The boys have made me breakfast almost everyday, and even lunch when DH was mowing the lawn.  I think they've done an amazing job for being 9 and 6. 


It's sad when your big activity for the day is taking a shower.  Although, I did wander out a few times. One trip to Target with the boys.  I have to say I love the scooters.  The boys both wanted a little ride on my lap which worked for about 5 minutes.  I only managed to bang into a few clothing racks (totally embarrassing when you have to go in reverse with the loud "beep, beep").  I think everyone stared at me though, but thank goodness I had that heavy splint on. 

Sleeping with a huge splint on also is extremely annoying.  The first few nights were ok, since I was on pain meds that knocked me out. After a few days though, it was rough.  I don't like sleeping on my

back and I move around a lot at night.  So,  finally managed a way of resting my splint on a pillow so that I could comfortably lay on my side.  Also, getting up in the middle of the night with crutches kind of sucks. 

Ok, so enough with the complaining.  On a positive note, pain has been minimal.  My incision site on the medial side is the one that hurts but I knew that one was going to be bigger.   I didn't know how much bigger since it was wrapped up for 12 days.

Yesterday, I had my follow up appointment.  Here's what I wanted to hear: "Incision looks great, wear your boot, until you can walk without it. No need for crutches anymore.  Feel free to start PT and go ahead and start spinning.  Run when you are ready." 
Here's what I got:  Incisions look great, wear your boot for 3 weeks, no need to start PT yet since they won't be able to do much for you right now, no spinning unless you want a world of pain, crutches as needed. boo.

He did tell me exactly what they (Dr and Resident?) found.  I had a menscoid legion between my fibula and tibia from a high ankle sprain (assuming that was with the initial avulsion fracture) that wasn't the source of my pain but they took it out anyways, they cleaned up the inflammation in my ankle joint called synovitis, and took off 2 bone spurs that were on my talus and my tibia that would bang into each other (otherwise known as kissing spurs) when I flexed my ankle.
 

All the inflammation was from the spurs not arthritis like he thought.  My cartilage looked great, no lesions.  I'm extremely happy about that since I never believed I had arthritis. I had the symptoms, yes, but I couldn't wrap my head around having it.  I probably would still be in denial even if he told me I had it.  

So, finally got the splint off.  I have a tiny little incision on the lateral ankle side and a bigger than expected incision on the medial side-about 2 inches.  Leg hair shorter than expected (thank God!), and I could actually flex my ankle a little bit (enough that Dr was impressed I do that much after splint).

last of the Oompa Loompa Skin plus some lovely stitches

Pampered ankle with steri-strips and nail polish!

So I get to use my boot again, the ankle is in a different angle now so I'm feeling the incision area more, crutches still.  I can at least put my foot down with minimal pressure on it but it's a start.

Arthroscopic Ankle Surgery Update

** Warning** nothing gross to tell, but I know that I was looking for info on surgery, I read some people's blogs to get a better idea of what to expect so...depending on who you are, you may or may not find this interesting.

As you can tell from the warning, I like to know what to expect so I'm ready, but unfortunately, that also makes me get anxious about what is about to happen.  Oh, well.  

Surgery was planned for Friday, June 28.  Finally got my paperwork from the Dr's office the Tuesday before and the call from the hospital the Wednesday.  I was told I needed to stop by and pick up an anti-bacterial soap that I had to shower with night before surgery and day of surgery.   No food or drink after midnight Thursday.  I had to be at the hospital at 11:00 am. My surgery was planned for 1:00 pm (of course this is the week I've woken up starving every morning- unlike my normal no appetite until 10am)

Friday:
Chilled out at home, trying to keep myself busy- cleaning, laundry- anything and the coffee smelled so good, and I was hungry.  I guess,in a way, hunger was a good distraction.  Dropped the kids off about 30 mins before at our neighbors then we headed to the hospital.  My Dr told me to bring my big black boot and the nurse later told me to bring the crutches "just in case." We discussed in the car if we should bring in the crutches into the hospital or leave them in the car, but decided DH could go get them if I needed them.  Chances were pretty good I'd be wheeled out, right?  

So waited around for about 20 minutes, got tagged with my information and drug allergies, signed off on my official procedure "ankle arthroscopy with debridement and excision of talus".

 Then waited again before heading back with the nurse.  This part is all new to me.  Got to sign off on a blood transfusion, if needed (gulp).  Officially, weighed in- my normal weight (whew), lovely gown and red slipper socks (gulp, starting to feel real), pregnancy test (neg- that would have been a shocker!)    another foot scrub with antibacterial soap (how many times does a foot have to be washed?), then got to go back to my little area, got on my bed, got my vitals taken, and the nurse started an IV, etc.(gulp).  DH got to come back and hang out with me for a while.  My Dr's resident stopped by to see if I had any questions about what I was having done (nope- I kind of looked into that online- looked easy enough- although the excision of talus was not online) (Dr explained he might open the ankle up a bit more than the ankle portals for the arthroscope to get to the spur so I figured that was that.) Resident marked a yes on my left leg and initialed it- good, the correct leg was getting worked on. 

just put scrubs on him w/o the drink, my anesthesiologist

Then the anesthesiologist (who totally reminded me of Sal from Mad Men) stopped by to explain what he was going to be doing.  I was getting a nerve block behind my knee and he'd be doing that a few minutes and DH would have to leave so they could do that since the had to use a ultrasound machine to find the nerves and I might be a bit loopy too since I'd be getting something to relax (um, ok).  Well, I don't know about loopy but it took me about 30 secs after to feel the effects of what ever they gave me.  Wow.  That was nice, just chillin' out.  They propped me on my right side and worked behind my left knee.  I really don't remember feeling much at that point, but I remember them asking me if I could feel my toes, which I couldn't.  They let DH come in and give me a kiss and I got my lovely hair net/hat thing.  Then I was off to the OR. 
 Honestly, the OR was bright and cold, and I remember seeing my Dr looking at my MRI in the corner, then the nurses helped me move over to the table, strapped me down, asked me to move my arms out, they put a mask on me, which was only to one side of my nose -not centered- I remember saying something about that, then someone saying "medicine going in" then I was out.

In the recovery area, I remember hearing voices first, then trying to open my eyes for a while then falling asleep again.    Eventually, I stayed awake enough for them to talk to me.  I got my glasses back which helped a bit, then they brought DH back to stay with me.  I remember that my ankle was hurting a bit especially on the medial side. 7 in pain.  Sal stopped by to see how I was doing with pain, told him it was hurting and he said that area of my foot wasn't covered by the nerve block.  Great.  Got to eat a bit, saltines and graham crackers and drink water.  I was given Percocet and told not to wait to feel the pain but to take them on schedule so I could stay ahead of the pain. 

Just a spray tan from my knee to toes

 I was expecting to see my big black boot which went with me to the OR on my leg but instead I have a lovely splint wrapped in an Ace bandage with my orange Oompa Loompa toes sticking out.

 Dr. talked to my DH while I was still sleeping. Dr said that he did what he'd planned to do, there were no surprises, "cleaned it out" "shaved off the spurs" (spurs? multiple?- thought I had only one) and he opened me up a bit to get the one and DH used fingers to show a maybe an inch or more something else about the arthritis but DH didn't follow the medical jargon. 

Other than not wearing the boot, I was also surprised by my discharge instructions:  Non-weight bearing until given permission by Dr, no driving until given permission by Dr.- wait, what?  I have things to do next week! I have kids going to camp, I have some professional development workshops to go to. No driving?! Ok, I get the pain killers and driving but if I'm not on them? then can I drive? Ugh, Dr appt not scheduled until July 10th.  It was the earliest I could do. I wouldn't have schedule all this stuff if I had known.  Dr told me "boot for 5 weeks and I'd be back to spinning a few days".  grumble.  Hopefully, no more surprises. 

But, wait, there are more surprises...
 I can't do Percocet- found that out on the way home from the hospital.  Barf x2. Thank God, we keep plastic bags in the car for that.  Then, I'll just say the next 24 hours is a repeat performance.  I tried a change of medicine, Tramadol did the same thing.  Finally took an anti-nausea combined with the Tramadol which just knocked me out for about 4 of the 6 hours between doses.  Fine. By. Me.

So, now I'm 5 days out from the surgery.  I stopped taking anything on Sunday pm to test the pain scale. It was within a tolerable amount so I'm off the meds.  I feel back to normal until I get up then my ankle reminds me that it hurts.  So, I'm here parked on the couch with the foot up, the Tour de France on TV and Netflix a click away.

Plus, DH got me a shower bench for bathing so I can shower and nifty cast cover thing that actually works.  So, clean hair, shaved legs and fresh clothes make a world of difference.  Ahhh.

So, I'm in recovery mode for a bit.  Really hoping that I'll still be able to run the Air Force Half this year. (really kicking myself for registering so early!)  But I like having it as recovery goal too, so, we'll see what the Dr says, hoping it's 3 weeks in the boot (for the 5 weeks total he gave me earlier) so that I have 6 weeks to rehab and train?  Yeah, even typing that seems ridiculous.  Then again...


Before I can close, I have to say thank you to my DH for taking care of me and my minions, Cub and Buster for fetching me basically everything when I need it. My dear MIL who helped out SO much on Saturday with all my lovely medication problems and my awesome neighbors who watched the boys for us.  Thank you, again.  

Ankle Surgery Decision

Back in April I had my MRI and discussion with my Dr about my ankle pain.  You can read about that here. I managed to do my big races at the Flying Pig in the beginning of May with not much pain.  Granted, compression socks and Advil were a pivotal role in my success. My PTs were very surprised that I was able to finish all three races and were expecting a mess when I came in on the Monday after.  My ankle was sore and crunchy but I could walk w/o pain. 

My newest PT, I'll call her Michelle, who comes from a sports clinic, gave me the talk.  "You need to stop running for 2 weeks and completely rest it.  It's not about running now, it's about running in the future."  Yep.  She's right.  Grrr.  So, I was good.  I rested for long 10 days.  Meanwhile, Michelle looked at my new running shoes that showed up in and deemed them unfit for my foot.  I have always wore a Neutral shoe (Mizuno Wave Riders) but she showed me why I needed to be in a shoe for Supination.  I had 2 weeks to try out another pair of shoes and return the old (new) shoes.  I was getting close to 2 weeks but I hadn't got to run in them yet.  That was part of my reasoning for starting to run again but also, my ankle felt the same even with rest.   If I try to dorsaflex, stretch my calf, lounge, walk up hills, walk down stairs it still hurts.  (Michelle gave me her blessing to go ahead and run again)

Michelle asked me when I was going back to the Dr. for a follow up- I told her I wasn't.  My Dr. told me to come back when the spur was killing me and we could do a "scope" to clean it up and shave off the bone spur.    Michelle looked at me, nodded her head and said "Just do it, it's stopping you from doing what you want."  She explained to me the general recovery for it and said I'd be walking within a day or 2.   Ok, doesn't sound THAT bad.  
 

I'm not a radiologist, but I think that's a spur hanging down from my tibia (left hand side, in the middle of the red triangle)

So, here I am, waiting to have arthroscopic surgery on my ankle spur(s?) next Friday.  My Dr. told me that he might have to open me up a little bit more than just the portals for the arthroscope to get at the spur- just depends when he gets in there.  Recovery would be 5 weeks in the BOOT and nothing about being non-weight bearing so that's good, although I did clarify with the nurse and she told me to bring my crutches and boot to the hospital, so...fingers crossed that will only be for a little bit. 

 I do have my doubts.  I can run with little pain.  BUT, I'm in pain later.  Today, I went for a run and as usual I was hyper-focused on my ankle.  It didn't hurt to bad, just on hills (up and down) and I thought "Why am I having surgery on this? I can function, with some pain, but it's not horrible."  BUT, if I didn't do anything about it, I'd stay in this stupid, frustrating situation.  Run, then pain, repeat. 
I want to compete. I don't want to have to run every other day and only 3 miles. I don't want to be the person who can't run because it hurts her ankle too much.  I refuse to stop.  So, I guess that's it.  I have to get this taken care of.

My PT added some anxiety since she asked me if he was going to be doing a micro fracture on the ankle and asked if Dr brought up OCD (Osteochrondral defect).  He didn't, thank goodness, since Dr. Google brought up some scary stuff.    My real Dr. did not mention this, and when I look at my patient summary for the surgery it mentions "General or localized osteoarthrosis" which means I'm old that I have arthritis. If you google "localized arthritis" it is this OCD stuff. I looked at my MRI and at MRIs online of an OCD of the ankle and I think I'm good- but then again, I'm not a radiologist.  (Although it is fascinating, maybe a second career option...) 

my lovely ankle MRI of my talus

someone else's MRI with OCD in the talus

  Since, if I timed it right, 5 weeks in a boot gets me to Aug 2 (perfect for me-done with it before going back to work mid August), and gives me 6 weeks to train for the Air Force Half which stupidly I signed up for back on Jan 1.  I'm hoping this is an easy recovery. 

Has anyone had arthroscopic surgery on their ankle before?  I'd love read about your experiences.