1 March 2015
(48 days post-op)
In the boot: almost 5 weeks.
I have not used crutches ONCE today! Yippee!
28 February 2015
(47 days post-op)
In the boot: over 4 weeks
27 February 2015
(46 days post-op)
In the boot: over 4 weeks
PT today! Walked around on one crutch pretty much all day. Foot hurt slightly more than usual, but not terribly. PT went really well. I’ve been worried that I’m moving too slowly, but before I could even ask about that, Dr. Mossberg reassured me that I”m going at a normal pace, and to continue at the rate I’ve been doing. It was very nice to hear him say that! PT actually felt much easier today than it has in the past. I wonder if part of it was that there were two days in between PT appointments instead of just one? Also of course random chance.
He told me to add sickling my foot to my daily movement routine.
I take a few steps around without any crutches, usually in my apartment.
26 February 2015
(45 days post-op)
I was at a day-long conference up in San Jose so I didn’t get a chance to take pictures! I did elevate my foot and do exercises all day, but it’s pretty swollen and uncomfortable right now. Maybe from flying? Anyway—it’s not TOO bad…but more uncomfortable than it’s been for at least a week.
25 February 2015
(44 days post-op)
24 February 2015
(43 days post-op)
Forgot to take pictures this morning! Whoops.
Normal day – walked around all day with only one crutch! It got a liiittle bit sore by the end of the day, and I was leaning on the one crutch pretty heavily. PT in the evening – pretty much the same exercises as last time!
23 February 2015
(42 days / 6 weeks post-op)
Today I walked from the kitchen to the living room with no crutch! Without even thinking about it! My foot feels stiffer today than it has recently, but this bodes well. We’ll see how it feels later tonight…haha.
22 February 2015
(41 days post-op)
Pictures and video from today. Here’s today’s picture next to the picture from yesterday for comparison. It’s hard to compare with the one I took on the 19th, because the angles are so different, so I think I’ll compare with the on from the 21st from now on. Plus a video by special request. This one is actually very helpful for seeing how stiff my leg leg still is!
VERY encouraging excerpt from an academic article about various ankle soft-tissue solutions:
THE BROSTROM-GOULD PROCEDURE
Between the years of 1964 and 1966, Lennafi Brostrom published a series of articles discussing the management of soft tissue lateral ankle injuries. The procedure he described involved identification and shortening of the elongated collateral ligaments without the use of synthetic materials or other autogenous structures. This procedure was modified by Nathaniel Gould and included mobilization of the lateral portion of the extensor retinaculum and attachment to the distal fibula, superficial to the ligament repair. Because the extensor retinaculum arises from the calcaneus and courses parallel to the CFL, the component of subtalar instability is also addressed as well as reinforcing the primary ligament repair. This procedure is particularly ideal in athletes such as gymnasts and ballet dancers who need preservation of subtalar joint range of motion, as well as peroneal muscle function and strength.
Hamilton, in 1953, reported the results of 28 modified Brostrom procedures with 55% of the patients being professional ballet dancers, and the rest comprising recreational athletes and nonathletes. The average follow-up period was 7 years, and the results were 26 patients with an “excellent” outcome, 1 “good,” and 1 “fair” resu1t.
21 February 2015
(40 days post-op)
When I’m at home, I’m pretty much only using one crutch to get around! And I’m baaarely using it. Doing pretty well!
20 February 2015
(39 days post-op)
19 February 2015
(38 days post-op)
Pictures and video from this morning! I’ve gotten out of the habit. Heading in to work leaves me less time in the morning to take pictures. Also, the swelling has almost completely gone down so the pictures I was taking are kind of boring now. Hence the more ROM-focused ones!
PT was much more intense today – instead of 2 sets of 20, I was up to 3 sets of 30 on every exercise. Again, pulling weights with my foot, leg swings in the airboot, hamstring and quad pulls, and some squats and heel raises on the right leg. He also always starts off with an amaaazing foot massage. I don’t know what he’s doing, but it feels really good and my leg seems to sort of relax afterwards. It’s lovely.
Home now and have a massive headache :( This seems to happen when I do PT, maybe? Not sure why.
18 February 2015
(37 days post-op)
I worked my first full 8 hours today, and I can pretty much say it was a mistake. My leg hurt SO much when I got home I basically crutch-ran from the car to my apartment and laid down immediately. I’m not sure I should do that again. Maybe it’s also partly because I had PT yesterday… anyway I’m going to take it easier after PT in the future.
17 February 2015
(36 days post-op)
Pictures from the morning.
First real day of PT! He had me do a ton of leg exercises – on both legs. I did squats and heel raises on the right leg. He also hooked up some weights on a complicated pulley system, and hooked a leather strap around my foot and I did some dorsi and plantar flexing. I also got a weight around my leg in the boot and did some leg swings for hip strengthening. It wasn’t too bad! In fact I kind of wanted him to push me more – I’ll have to ask for that next time.
16 February 2015
(35 days post-op)
1pm Leg doesn’t feel quite as great today as yesterday. I’ve needed two crutches all day so far. Now I’m relaxing, toes level with nose, and doing some gentle non-stop flexing.
15 February 2015
(34 days post-op)
Holy cow my leg felt great today. I spontaneously got rid of one crutch and only started using one! Felt very solid walking around. I ran a bunch of errands today, and worked on a project. Leg started to hurt around 5:30 so I called it quits and put my toes above my nose for some more gentle flexing. So busy I didn’t take any pictures :)
14 February 2015
(33 days post-op)
Slept without the boot.
Mostly felt really good! I find it’s hard to keep the boot off for long periods of time when I’m at home because I have to stand up and walk somewhere (the bathroom, the kitchen, the other side of the living room, etc) really frequently. I probably only had the boot off, doing exercises for about 4 hours today.
13 February 2015
(32 days post-op)
Slept without the boot again last night. Woke up twice :(
I had the boot off for about 4 hours today while at work – and I spent that whole time doing exercises with my foot. It felt pretty ok! I did dorsi/plantar flexing and some winging out. I’m about to check out the video and see how it compares to the earlier ones.
Video compared with 29 Jan 2015, there’s a big difference in the quality of movement – much faster and more confident! – but hard to tell whether the ROM is actually increasing. It certainly feels better though!
12 February 2015
(31 days post-op)
I slept without the brace last night! I also woke up 3 times. Not 100% sure if they’re related.
Now I’m sitting around with no brace, just wiggling and moving my foot as I sit here! Yay! Movement!
Went to my second PT (at a different office – just to try things out). I liked him MUCH more! They both seemed capable and knowledgeable and personable but I just felt more excited and inspired by the second one (his name is Gunnar). Gunnar spent a much longer time asking me about my physical history, asking about the history of the ankle, and especially asking me about my goals. I listed my goals as acrobatics (high impact), backpacking (endurance), and ballet (strength and flexibility). He was most cautious about the ballet – saying I should have in my mind that it would be 9-12 months of physical therapy, and it might take a lot of hard work. But he seemed totally supportive and I felt inspired and happy! Gunnar also spent most of the visit moving and exploring both of my ankles to get a sense of what could move and what couldn’t.
He told me to move my ankle more or less constantly all the time, and never to turn it in (sickle it, in dance terms).
11 February 2015
(30 days post-op)
Pictures in the AM
First day back at work and first day of PT! I went to Scripps Physical Therapy and Hand Center and met with Todd Sparks. He seemed very nice and personable and I felt very comfortable. There are a ton of pictures of athletes on the wall, with signed “Thank yous” to Todd Sparks. But when I asked about whether they had been treated there, the front desk lady just kind of grunted noncommittally and didn’t clarify. Todd had me remove my boot right away, and actually got me up and taking some steps without the boot on. I was very nervous about that but it felt fine. He also taught me how to walk around with just one crutch, and then we did measurements on the ankle and looked at ROM (range of motion). He taught me 6 exercises to do, and at the end put a little electrical stimulation machine (doing H waves) on my ankle. That gave me a headache almost instantly. I went home afterwards and iced my foot and pretty much fell asleep.
My ankle actually felt great all day.
PT was painful, but I kind of expected that.
He wanted me to walk without the boot every day, and have the boot off as much as possible.
I’m also supposed to just touch my leg and especially the incision to get the nerve weirdness to chill out. I get crazy tingling sensations shooting into my toes whenever someone touches the incision site, so it’s nice to know how to get rid of that!
He also measured my current ROM. My left foot has 6 degrees of dorsi flexion (compared to 20 on my right) and 24 degrees of plantar flexion (compared to 75 on the right…50 is considered normal haha). He warned me that I might never get as much range of motion in my left foot as in my right :(
10 February 2015
(29 days post-op)
4am – Woke up feeling good. I took a shower and scrubbed the living heck out of my leg left. It itches SO MUCH. I put lotion on half of it to see if that has a positive effect.
7:30am – Sitting down without the cast is so great!!
4:30pm – Pictures and video. Stretched my scar tissue!
5pm – Went grocery shopping! I basically bought milk, mushrooms, and broccoli because I can’t carry anything haha. But that little grocery cart is pretty fun!
Doing research on PTs in my area:
Scripps Ranch PT Yelp Reviews – look mostly good, although there are only 10 reviews. I really want someone who has worked extensively with ankle surgery recovery, and also who does sports recovery because I want to get back to a VERY active lifestyle.
Todd Sparks – PT (as opposed to PTA, that’s good), DPT (got a clinical degree in PT, that’s good), MPT (masters in PT that’s great), and CSCS (Certified Strength and Conditioning Specialists). Specializes in “orthopedic disfunction” which just refers to muscoloskeletal issues. The site mentions that they do post-surgical work including tendon repair and their therapists do trainings every year.
Gunnar Mossberg, PT DPT MOMT -No idea what MOMT is. Yelp reviews. I like that he emphasizes his education, and was an instructor at the Ola Grimsby institute. Also, on this list, he’s described as “Practice Focus: Direct Access, Manual Therapy, Orthopaedic Injuries and Conditions, Post-surgical Rehabilitation, Sports Physical Therapy” which is….. everything I want. The FAQ on their website addresses a lot of the questions I had (no PTAs, same therapist for each appointment, etc).
Annnnnd Mossberg is totally booked until the end of February. I find that super frustrating. I waited until now to start doing research into PTs because I thought I needed to get a recommendation from my surgeon. I kept asking and asking the surgeon’s office and they would only reply with something along the lines of: “We can talk about that when it gets closer to the time.” And then when I got approved to go in for PT, he told me I can go anywhere I want! Why didn’t they just say that??? I think they thought I was trying to start actually going to physical therapy right away, but really all I wanted to do was make an appointment for the future. UGH. WHY DID I WAIT.
9 February 2015
(28 days post-op)
6am – Foot feels fine!
7am – Breakfast and a shower. Foot feels ok. Still only putting about 60% weight on it.
9am – Left for a post-op doctor’s appointment! The surgeon thought the scar looked pretty good, and told me:
0. In general, I need to keep my pain levels below a 3/10. (That sort of means nothing, since there’s no guarantee that we have the same definition of what 3/10 means, but it DOES encourage me to keep listening to my body, and slow down if I’m in too much pain. No need to push myself).
1. Start massaging the scar, pushing and pulling it up and down with my fingers to prevent scar tissue.
2. I’m allowed to keep the boot off whenever I’m sitting or sleeping, but I still need to have it on when I’m standing (putting weight on it) or walking.
3. I can go to PT!
4. If I go for 2 days without using the crutches to walk, I can completely ditch the crutches.
5. If I stop using the crutches, a few days later I can start removing the boot for walking. He recommended starting in the AM, and putting the boot back on as my pain levels go above a 3/10. Eventually working up to being a full day w/o the cast.
He also said since I’m still having quite a bit of trouble walking for any reasonable amount of time, or sitting up for more than a few hours, taking another week to rest would be recommended.
3pm – I’ve been sitting with my foot elevated for about an hour now, and right at 3:20 my dang ankle just started to throb and be very uncomfortable! So interesting.
4pm – Pictures. Still super swollen feeling! And hot. And the skin is itchy.
5pm – Argh! So uncomfortable! There’s no position that’s comfortable. Everything hurts!
6pm – Ugh! I don’t really get this. I didn’t really do too much today. Ouchhhh :(
7pm – taking 400mg ibuprofen.
8 February 2015
(27 days post-op)
5am – Foot felt fine when I woke up!
6am – Breakfast, put about 50% weight on it walking around, feels good!
7am – Still going strong. Took it out of the boot for a bit. My skin is super irritated. I scrubbed it in th shower for a solid 15 minutes. Seems to have helped.
11am – Drove down to meet a friend for lunch
12:30pm – The 2 block walk back to the car was actually fairly uncomfortable I’d give it a 3.
1:30pm – Ok walking around my apartment
3:30pm – My friend came over and we hung out for a few hours!
8:30pm – which is how it got to be this late and I didn’t take pictures, haha.
7 February 2015
(26 days post-op)
7am – My ankle feels very tender. I don’t want to put any weight on it. Putting a little bit hurts. This is the first time it’s hurt in the morning… :(
9:15am – out to the car for a work event, where I discovered my battery was dead, haha.
11am – arrived at the work thing
12pm – lunch – standing in line at Chipotle hurt a bit
2pm – my leg was starting to hurt a bit. By this point in the day I’d actually done the most walking I’ve ever done, going from cars to the school, back to cars, into chipotle, back to the car, back to the school. My leg felt a little painful and swollen. I was mostly sitting up all day, but I did find ways to elevate it a couple of times.
5pm – Still can barely bring myself to do exercises. My foot feels very tender and sore and stiff. I took some pictures and did try to to the movement. It was very painful. I’d give it about a 4 on the pain scale.
6 February 2015
(25 days post-op)
7am – Breakfast and walking – easy to put weight on it!
10:30am – took the airboot off. Light exercises felt a little stiff and painful, but not too bad.
12pm – Snack and walking.
1:30pm - Dorsi/plantar and side to side.
2pm – Lunch and walking. I basically carried the crutches! Putting weight on my foot doesn’t hurt. Now that I’ve been sitting down for a few minutes, my leg is starting to ache a little bit. I’m cautious about overworking it, so even though it felt fine to walk around the apartment a little bit and get lunch ready, I don’t want to push things too much. I’m resting with my foot on the ground and it’s hot, itchy, and feels a bit swollen.
2:20pm – Pictures. Overall I think my foot is looking MUCH much better. I tried to capture the one part that strikes me as crazy swollen – the back of the ankle. There’s a picture of my right ankle for comparison.
3pm - did a foot shower. My skin is soooo itchy and dry :( Walking to the shower was quite painful – I didn’t want to put any weight on my foot at all. Elevated it as soon as I was back on the couch.
6pm – Dinner. As soon as I stood up, lots of foot pain!
8:3pm – About to hobble to bed. Leg feels ok if it’s elevated, but putting it too much lower than my heart makes it throb, and putting weight on it will probably not really be an option…
5 February 2015
(24 days post-op)
5am – woke up. Read for a while with my foot elevated.
7am – Breakfast. Worked up to full weight-bearing – felt good! The cast is hurting again as it rubs on my foot as I walk.
12pm - Lunch and pictures. Light exercises (dorsi/plantar flexing, and side-to-side plus floor-circle-pressing) all felt pretty good. Not as easy as yesterday… but still pretty nice.
3pm – Swelling right on schedule. I laid down to take a nap at almost exactly three, which actually seems to have been a great idea.
6pm – Dinner. My foot is CRAZY hot right now. Also it itches like mad. I’m resting it on the floor now – free of the cast, that seems to be normalizing things.
4 Feb 2015
(23 days post-op)
Julian pointed out that when the surgeon said “You can put full weight on your foot now” I interpreted that to mean “You can walk around like a normal person and should have zero pain”. Those are not the same thing. So even though I’m usually a little worried about how I’m healing, things are really moving at a pretty good pace. I’m also a little concerned about going back to work on Monday, since I can’t sit upright for more than a few hours at a time, and walking for more than 10 minutes is very difficult! I usually have to rest with my leg elevated after doing either of those, which will be harder to do at work.
I have a doctor’s appointment on Monday, so, we’ll see what he says.
10am – I’ve been sitting on the futon for about an hour now, with both feet on the ground, and my leg is tingling a lot and fairly uncomfortable! Time to either go for a walk or elevate… or both.
12:30 – removed the airboot for pictures and exercise. I definitely feel like my foot is less swollen than it has been before! I don’t think the pictures are actually showing the part that IS still swollen, which is the back part of the ankle, just behind the incision. I’ve attempted to take several pictures, but I just don’t feel like they capture what’s going on.
Dorsi/plantar flexing. This felt sooo easy! I don’t think I’m going any further, but it felt much easier to do. I felt like I was moving more quickly than before.
Side to side. Still pretty hilariously difficult.
3:45pm – Yep, right on time. Lots of discomfort in my foot. I took off the airboot and the top of my ankle is significantly more swollen than it was before! Interesting… Went for a quick walk that I had to cut short due to discomfort. The airboot is still off – I’m hoping that’ll help the swelling go down.
It did help! I guess that’s the best thing once it gets crazy in the afternoon like that.
8:30pm - sudden swelling and tingling again. My foot has been resting in the boot, but the straps haven’t been folded over, so there’s very little compression of my foot happening – just support holding it in the right position. AND it’s been elevated for about 2 hours while I did some work on my computer. NO idea what to do to make it feel better…
3 Feb 2015
(22 days post-op)
I don’t think there was anything notable about my leg today… I played things kind of cool, but continued my habit of putting as much weight as possible on it every time I would go walking (to the bathroom, or the kitchen for food, for instance). I did end up taking pictures around 5pm – to me, it looks like my foot is quite a bit less swollen! I also did do some dorsi/plantar flexing today, and it felt pretty great! I wasn’t moving much more than I have been, but my foot felt much less stiff than it has been feeling.
Pictures from today! I also want to mention that for a few days now the skin on my left foot has been peeling. Actually it’s my entire left leg – everywhere they had put the orange antiseptic rinse. I guess it dried my foot out like crazy. And the skin at the bend in my ankle is very rough and scaly feeling. Gross!
Around 3pm my leg started getting super uncomfortable again… I definitely think it’s related to the time and not my activity level.
When I got up from the couch in the living room to go to the bedroom, I ended up bumping my leg on the table and somehow twisting it around. Luckily it was in the “good” direction (outward – like winging my foot as opposed to sickling it, if you know dance terms). It didn’t hurt but I was slightly concerned. Then later that night my foot became INSANELY uncomfortable. I was getting very sharp pains shooting up through my leg, and given the twist from earlier I was worried that I had somehow hurt myself :( I took the airboot off, and there was a huge puffy section of my foot that I hadn’t seen get puffy before. I sat with my foot out of the aircast for about 30 minutes and it eventually subsided, but putting the airboot on again was not my favorite.
It feels like I’ve had lots of issues with circulation… I don’t know if that’s normal.
2 Feb 2015
(21 days post-op)
This day we actually drove up to LA! Julian got very sick on Sunday night, and I didn’t want him driving while feeling so ill, so I drove us up to his grad school visit at USC. My leg actually felt amazing the entire time! In fact, we stopped for gas, and I almost got out of the car without crutches because my leg felt so normal! I have no idea why that was.
I spent the rest of the day relaxing in the car. My leg felt fine until 3pm, when it suddenly got insanely uncomfortable.
The timing seemed odd to me, and I started wondering if my leg hurting in the afternoon had anything to do with my daily activity, or whether it was just “3pm pains”. 2:30-4 are usually my “crash times”. For instance, I usually start wanting to take a nap at work around 2:30 or 3, and when I have a cold I usually feel much better in the mornings and start going downhill again around 3 or 4. So it…kind of makes sense?
I didn’t take any pictures this day either.
1 Feb 2015
(20 days post-op)
(My boyfriend was visiting here, so my notes got a little.. less important haha).
My foot was feeling pretty tender, and I started getting really nervous about doing dorsi/plantar flexing, so I decided to take a small break from that. Instead, I’ve been leaving the cast on, but making sure that I put full weight on it every time I walk. Previously, I was putting full weight on it only a few times a day, but my Dad mentioned that using the muscles is partly how your body pumps lymph out of the area, so I thought it might help with the swelling. So now, every time I stand up, I do a few gentle weight shifts to get my foot used to the idea, and then put as much weight on it as I can. Putting weight on my foot never seems to hurt. *Walking* hurts – again, I think because of the way the airboot rubs against my tender ankle. Being upright for more than 10-15 minutes also starts to hurt pretty badly. It’s very difficult for me to imagine heading to work next week…
Julian and I went on a little excursion to the grocery store! Getting down the stairs wasn’t too bad – I still use the sit’n’scoot method, which makes it almost impossible to carry anything that’s not directly tied to my body. I won’t be able to do laundry by myself or get groceries until that gets easier, I think.
The grocery store has a little motorized cart that I could use. It was pretty fun! Great turning radius. The only problem was that the power was weight-triggered, and if I didn’t perch on it at hte right angle it would just turn itself off. Kind of useful as an emergency brake though, haha. After about an hour of wandering around the store my leg was VERY uncomfortable. I had to elevate it as much as possible when going through the checkout line because it was throbbing and pressing against the aircast like crazy. The rest of the day I pretty much rested with my leg up.
I didn’t take any pictures this day.
31 Jan 2015
(19 days post-op)
4:30pm – Gentle exercises and pictures.
5:45pm – I took it fairly easy today. My foot has been quite tender the last two days.. I’m not sure why. So I’ve been taking it a little easier. I did the gentlest of exercises today, but I felt like the range of movement was much smaller than it had been. I could barely bring myself to do the dorsi-plantar flexing. My foot is tender to the touch – like the whole thing is bruised. Walking wasn’t too bad – it feels like the pain is more in the boot around my foot rather than putting weight on it. My whole foot is tender and feels bruised when I poke it with my hands.
9:30pm – The evenings are always the worst. I also forgot to take any ibuprofen with dinner…It’s very hard to find any comfortable position. Any angle presses the airboot against my ankle and hurts.
30 Jan 2015
(18 days post-op)
Yesterday evening my ankle felt mostly good. Just before going to sleep it became extremely sore and tender.
8:30am – breakfast + 200mg ibuprofen.
11am – Walked around for about 30 minutes. Felt great again! I put almost full weight on it, just using the crutches for balancing.
1:30pm – Lunch + 400mg ibuprofen. Foot started to feel tender here…
4:30 – Pictures, then exercise. I didn’t do the dorsi/plantarflexing today, because my foot was just too sore.
29 Jan 2015
(17 days post-op)
Last night was sooo much better than the night before. My leg barely hurt at all, which was a huge relief. There was one weird thing, which is that around 8:30pm the top of my foot suddenly spasmed with a strange wave of pain. It felt like someone was stabbing me in the foot, but there was nothing touching it. That went on for only a few seconds, reappeared twice in waves, and then calmed down. But when I gently touched my foot later, it felt completely numb. It’s still numb and slightly tingly this morning. According to my research (bottom section) there can be some nerve damage during the surgery and healing process. Hopefully it’ll sort itself out!
7:30am – Gently working up to standing, as always – my foot felt FANTASTIC. I barely used the crutches to get to the kitchen. One difference is all the ibuprofen I took yesterday, but I also didn’t inflate the cast as much as I normally do. I wonder if that was pressing on the surgical site too much. Well whatever the difference is, it’s much better now than it was. Took 200mg ibuprofen with breakfast.
1:30pm – Lunch! and 200mg ibuprofen. I went to the bathroom earlier and for some reason one step hurt suddenly. A very sharp pain in the back left side of my ankle…hmm not good. I’ve been very careful about walking since, but I’m now 98% convinced that it’s the incision that hurts, not the actual ligament/surgery site. (Mainly based on how sharp and…shallow the pain felt). I’m going to work on creating a little pad or cushion over the wound, and see if that makes it easier to walk.
Pictures from today. Another dark day… I should also note that I took these pictures BEFORE doing any exercises, but the other photographs were always from after exercising, so that may explain any differences. I also added a picture of the back of both of my ankles. It was difficult to get the right angle.. but that’s definitely where my left foot is most swollen. It’s very obvious in person, but less clear in the pictures.
Note: In all of these videos, I’m going to where I barely feel just a bit of pain, and then backing off. It’s possible I’ll eventually need to push through that kind of discomfort, but I’ll wait until a Physical Therapist tells me that’s a good idea.
2:43 pm - OK!!!! My hypothesis that it was the *wound* that was hurting seems to have been correct! I added some batting (big cushiony stuff that’s inside quilts) right around my ankle, which both provided padding and also made the air boot fit more snugly, and I just walked around my house for 30 minutes with almost no pain!!! I’m so excited right now. But I’m going to gently rest my ankle for the rest of the day, just because I don’t want to push it.
4:30 – Just woke up from a nap. My ankle feels tender and sore. The boot feels uncomfortable against the wound. I’m glad I decided to take it easy for the rest of the day. I will probably take 400mg of ibuprofen tonight, just like yesterday.
7pm – Dinner + 400mg ibuprofen. I don’t want to have a hard time sleeping tonight.
28 Jan 2015
(16 days post-op)
Falling asleep last night was pretty rough. My ankle was swollen and painful from about 4:30 until 9pm. My boyfriend encouraged me to set up a regimen of painkillers to take even if I’m not feeling pain, and I think I’m going to do that. My plan is to take 400mg of ibuprofen with every meal.
7am – just finished eating breakfast and took 400mg of ibuprofen. Walking is painful – I’m only putting a slight amount of weight on my ankle at this point. Before I went to get breakfast I did some gentle warm-ups in the cast. Basically I press my foot into the floor while seated, then stand and gradually add more weight to the left foot while swaying back and forth or side to side for gentle weight-shifting. That feels fine, and actually today I was able to split my weight evenly between my two feet and feel no pain. I think what hurts when walking might be the scar rubbing against the inside of the boot. Might try to add some kind of cushion there – it might help me be able to walk more.
12pm – Lunch, walk to the kitchen of course, and 400mg of ibuprofen.
I also did a bunch of research yesterday, which I briefly summarized below, in the “Research” section.
2:30pm – Boot off for an hour. Pressed my foot into the ground, moved the knee around while keeping the foot still, and gently tried to point and flex. I’m much more cautious after it hurt so much the first evening.
Pictures from today. It was dark outside, so the lighting isn’t as good!
Video with dorsi- and plantar flexion. I’m much more cautious than I was on the first day.
Side-to-side movement. This is INCREDIBLY difficult for some reason. You can see my foot kind of jerking around. I have almost no control over it – it feels hilarious!
6:30pm Just finished dinner. My foot is pretty tender – I barely put any weight on it while I was preparing dinner. But it’s sooo much better than last night. Took 400 mg again. When I put the aircast back on after lunch I folded up the surgical sock I’ve been wearing so that there is extra cushioning over my scar region. I’m not sure it changed anything :(
27 Jan 2015
(15 days post-op)
My ankle felt pretty tender this morning when I woke up. Walking out to the living room to say goodbye to my Mom I barely put any weight on it and wanted to sit down right away. I think I’ll have to plan on eating lots of little snacks during the day – it’s just too painful to stay upright for more than 15 minutes.
8am – I have the boot off now, and I’m doing some very gentle exercises. Trying to move my foot under its own accord is a little too painful right now, so instead I’m using the cast to flex my foot. I’ve also started placing it on the floor, and gently moving my knee in circles while keeping my foot flat on the floor. My ankle feels pretty stiff and sore, but these moves are so gentle that I’m not concerned about hurting myself. Set the timer for an hour – I can’t have the boot off for longer than that!
11am – More exercises with the boot off. Discovered that pressing into the floor with all sides of the bottom of my foot feels pretty good.
Click here for pictures. Be forewarned, they are slightly disgusting! You’ll notice my left leg looks very orange. That’s the antiseptic rinse they did to prepare for surgery. It’s harder to see, but my leg is also fairly purplish in spots. I guess some of that is just normal swelling, but some of it definitely looks like bruises. The cast was extremely uncomfortable – it felt like my leg was trying to burst out of it. These bruises are the first indication that those sensations weren’t entirely inaccurate. My guess is that my leg swelled and pressed against the case, causing bruises. The super dark purple marks are from a marker the surgeon used. The last image is a closeup of the scar. It’s super puckered on purpose. The surgeon told me that skin heals better when it’s not under pressure, so they pull the skin taut and pucker it around the incision. That makes for a much cleaner scar apparently.
1:30pm - Washed my foot in the shower. The orange antiseptic fluid they used is staining the aircast and I’d like to keep it clean.
4:30pm – My ankle is suddenly tingly and feels swollen.. I guess I’ll elevate it for a while.
9pm – Took 200 mg of ibuprofen around 5, and rested toes above nose for a few hours. Then I hobbled to the kitchen for dinner and immediately went back to toes above nose. Took another 200mg, and now I’m heading to bed.
26 Jan 2015
(2 weeks post op)
I just got my enormous dressing off! The first moment the tech cut off the ace bandage that was binding it to me felt AMAZING. The last two days have been particularly bad – lots of swelling and tingling and general discomfort, so I’m VERY excited to have removed the cast thing. When they pulled off the bandages, the most painful part was removing the gauze from the actual surgical site. There was a ton of dried blood there, and pulling the gauze away stung slightly. Strangely, touching the surgical area sends tingling sensations down to my toes. It started bleeding when they pulled the gauze away, so the tech kept dabbing at it.
My foot feels pretty stiff and a little painful. The boot presses against my surgical wound, but as soon as that heals it should be pretty comfortable. Walking feels pretty great – I haven’t put full weight on my foot yet, but putting more weight on it while I’m in the crutches stretches out my calf and it feels FANTASTIC.
The surgeon cleared me to put weight on it, indicating that the amount of weight I put on it is up to me and my pain levels. He taught me how to do a three-point walk on the crutches (splitting weight between both crutches and the injured foot). It’s tricky but actually feels amazing to have some weight on my foot. I’m too cautious to walk with full weight as of right now. My foot feels…delicate. He also mentioned that the main function of the cast is to keep the foot in a 90-degree angle. Otherwise, the weight of my toes can stretch out the ligament again, and that is the last thing I want!
Resting in bed at home, so far I’ve kept my foot in the airboot, for the support. It makes me feel a bit nervous when it’s out of the airboot – like I can’t trust my ankle to take even a little bit of weight in whatever random position I happen to be laying in, so it’s better to have it supported by the cast. But I’m taking it out once an hour or so to do gentle flexing and pointing, or a short walk around my apartment. The airboot feels SO much better than the cast. I do think the cast was pressing strangely on some blood vessels. Since removing it, I haven’t had any issues with swelling or bloodflow. Walking more than 10 minutes (just around my small apartment) it starts to hurt, so I’m still taking it pretty easy.
By the end of the day, I’d done VERY gentle stretches on it 3 times, and take about 5 walks around the apartment (not counting bathroom runs – those are very short). By around 5pm my ankle region was pretty sore. I think that might have been too much movement for the first day. I took 400mg of ibuprofen with dinner, and still had a pretty tough time falling asleep because it was so hard to find a comfortable position.
General Accumulated Wisdom
> Wear VERY wide-legged comfy pants to the appointment.
> Prepare to not change your underwear much (it’s hard to get it over the cast)
> Sleep as much as you want to (sleep is very important for healing)
> Request the dang Handicapped parking permit here! They gave me the form to mail to the DMV at my 2-week appointment and it’s still not here (2 weeks after mailing it). I could really use it!
> Some surgeons recommend “toes above nose” for 23+ hours a day. That was impossible for me, but I did try to elevate as much as I could.
> Have a bunch of pillows around so you can prop various body parts up. Having my leg on top of a pillow eventually started hurting my hips, and then my shoulders. I ended up with 4 differently-sized pillows strewn about my bed and I have at least 3 of them in use almost all the time.
> Leave the light on in the bathroom (or anywhere you need to go that’s dark when you might use it)
> If you’re still using crutches, you can’t really carry anything. Huge comfy pants with pockets might be useful (I don’t have any) or a small bag you can attach to your body. A purse works well – a fanny pack might be even better.
> Do a dry run of tasks you’ll need to do on your own before your helper leaves. (I didn’t because I relish a challenge). You’ll find out what little things are total roadblocks. For instance, it takes me about 30 extra steps and lots of careful balancing to move my cereal bowl to the table. If we’d done a dry run, we would have seen this issue and could have rearranged the furniture to make it more accommodating.
> Attach a cell phone to your body at all times in case you get stuck somewhere and need help. I have mine in my purse that’s always nearby.
> Do gentle warm-ups to build up to putting weight on it. (Or, I mean – do whatever you want, but this seems like a good idea to me).
> Have a bunch of single-serving meals prepared and in the fridge where you can reach them. That way preparing food is as easy as pulling a pan out of the fridge and turning on the heat. I’m having a SUPER hard time reaching the bottom shelves. The veggie drawer is basically totally out of my grasp. Also standing for more than 10 or 15 minutes at a time hurts quite a bit.
> If the surgeon gives you little socks to wear under your airboot, get a few extra pairs. My regular socks are too tight to wear, and the one he gave me got kinda gross pretty fast.
WHAT TO LOOK FOR IN A PHYSICAL THERAPIST
“Today, graduates receive either a Doctorate (DPT) or a Masters (MPT) in physical therapy, whereas therapists who graduated several years ago received a Bachelors (BSPT) or Masters (MPT) with a similar level of education.” 
Used a licensed PT, not a PTA  
The second link  explains a lot of the letters after PT’s names: DPT, OCS, etc.
Good questions (how many patients do you see at a time? Do you specialize in my injury? Will I see the same therapist each time?) 
 12 degrees of dorsi/plantarflexion (pointing and flexing) (normal range is 65)
 Recommends only partial weight-bearing (PWB) in week 3, full weight-bearing (FWB) after week 4.
 Only starts discussing weight-bearing at week 6!
 Description of the procedure, describes the difference between Brostrom and Modified Brostrom. Recommends 6 weeks of non weight-bearing or only partial weight-bearing. Mentions a type of neuritis that can occur with injury to the superficial peroneal nerve, which can scar and cause pain or numbness.
 Begins weight bearing at 10 days, progressing to full weight-bearing as tolerated.