Healing Ankle

One Year Anniversary (8/28/08)

2008-08-28T15:11:00.001-07:00

To commemorate the day I broke my ankle on the one year anniversary, I decided to find all the blog posts that focused on my ankle and put them all here on one page. And I also wanted to write an update on exactly how my ankle is doing after a year.

It still hurts most of the time. It's not bad, just a dull ache that I can easily ignore. I still have a limited range of motion and even though I can't point or flex as far as I could before, it hurts to push it as far as it will go. Not being able to flex all the way causes the most trouble because when I am standing, the limit in the range of motion in my ankle means I can't bend my knee very far. This makes it hard to walk down stairs and I have to either go down one foot at a time with my right foot always first going up and last going down each step or I have to hop down with my right foot going down stairs because I can't bend my leg enough to get my right foot down to the next stair with my left foot still on the stair above. Running is still challenging, but I am able to jog short distances without it hurting too much. I can't jump up and down on one foot with the left ankle though and if I ever accidently land on it hard, it sends splinters of sharp pain all up my leg. The pain and range of motion is usually worse when it is raining or about to rain. But the swelling has gone down to the point of not even being noticeable most of the time. The scar has healed up nicely, but if you feel the ankle where the knobby bone should be on the inside, it is totally flat with the exception of the 3 pins that are sticking out. If you feel it, you can feel the 3 pins.

I don't seem to be limited much at all by my ankle when climbing, but the fall really messed with my lead head. I find it very hard to accept the possibility of taking a lead fall when climbing even when I know my gear is good and the fall is safe. But I am leading again and have led a few 9's and 10's this summer.

I am also able to walk in heals (even 4 inch heals) without limping! And salsa is usually no trouble at all!

I can snowboard without even noticing my ankle, though I doubt I would be able to do jumps since the landing would undoubtedly be too painful. Good thing I never did those in the first place!

I can do most yoga poses, though I have trouble with chair pose and can't go as deep into the pose as I used to. I also have to keep my legs much closer together in triangle pose or any standing pose where my left leg is extended but straight. And I have a lot of trouble with any balance pose (tree, eagle, etc.) where I have to stand on my left foot. However, I find heated yoga sessions to be very helpful in improving this.

It is doubtful I will gain any more range of motion at this point and my ankle might improve its ability to absorb shock, but it will probably never be the same. And while I do feel it all the time, it doesn't seem to be limiting me in my activities of choice, so I am happy to have recovered to this point and so happy to have my life back again. This ankle caused me to sink into a depression the depths of which I didn't even know was possible. And I am thrilled to report that I came out on the other side my usual optimistic and mostly happy self! I am still undecided on whether I will get the pins removed or not. From what I have heard from others with a similar injury, it may improve range of motion, shock absorbency, and reduce pain -- especially on rainy days. However, I am not at all excited at the prospect of another surgery and another month on crutches. Plus, removing the pins my weaken the ankle and I'm not sure I want to take that risk.

Mother nature has ensured that I wouldn't tempt fate by climbing today by making sure the rocks are all too wet. But I plan on taking my ankle out salsa dancing in Vancouver tonight to celebrate that I made it this far!!

Here are some pictures of what it looks like now:

The Scar

The Part That Shattered -- you can see that it's now flat and you can see the pins sticking out a bit

Flexing (and you can clearly see that knobby ankle bone is clearly prominent on the right foot and missing on the left foot).

Pointing:

Bending as far as I can on my left ankle:

And as far as I can with my right:

Climbing in the Gym (Written 2/2/08)

2008-08-28T14:33:00.002-07:00

So I made it out to the climbing gym again tonight and I actually did much better than I did last week! I climbed several 5.8's (I cheated on some holds for my left foot, but I figure I deserve that small handicap). Half of the climbs were overhanging which I struggled with even before I broke my ankle, so I'm pretty proud of myself. I also climbed both of the crack climbs in the gym (using face holds for my left foot) and met a bunch of very cool new climbing partners! :)

limping in high heals (1/29/08)

2008-08-28T14:33:00.001-07:00

I wore high heals today for the first time since my accident. I'm still walking funny, but I can manage in the heels and I'm so happy that I can walk in them at all!! And speaking of shoes, I donned my rock shoes for the first time last week at the gym. I'll have to ease back into climbing slowly since my foot is still not very flexible nor very strong, but I managed to get up a 5.7. It's been a long hard road and it feels so good to really believe I'm going to have my life back at some point! Hurray for high heels! :)

Walking ... sort of (written 12/19/07)

2008-08-28T14:31:00.000-07:00

Well ... almost. I was given the okay to put all of my weight on my foot a week and a half ago, but I wasn't able to until today. I've been using one crutch to get around and I've been taking my doctor's advice and trying to walk around as much as possible which leave my foot in a painful throbbing mess at the end of the day. But it's starting to pay off as today I finally walked down the hallway by myself with no crutches and without leaning on the walls. I still won't try to walk unsupported with no walls nearby as I'm still not very stable, but it's progress so for now, I'll take what I can get. I'm finally able to shower standing up which means no more chair in the bathtub!

I'm still really disappointed at my range of motion. It's getting better, but when I'm standing on my hurt foot, I can barley bend my knee at all -- which will make snowboarding and skiing in the future very difficult if it doesn't improve. I also still can't point my toe very far and I really hope wearing high heals someday isn't totally out of the question.

I can hardly remember what my life was like before this happened and it's hard to imagine a future where I can not only walk, but also climb, dance, snowboard, and do yoga. Through all of this I have realized that I am a very physical person and when I can't use my body to do the things I enjoy, I get very very depressed. I feel like I'm not even me anymore. I obviously won't be teaching yoga this upcoming quarter, but I'm hoping by spring, I might be able to. It's kind of depressing to look at the archives of this blog -- back when I used to use it to document my frequent climbing trips. I miss my life! The doc said I should be able to resume my normal activities by summer ... I probably won't be back to leading 5.10 cracks in Squamish by then, but at least I'll be back on the rock.

Starting weight bearing (11/28/07)

2008-08-28T14:29:00.000-07:00

I went back to my doctor today. It's about 3 months after the original injury (I can't believe I haven't put any weight at all on my left foot for over 3 months!!) and this appointment was where I'd find out if I was allowed to start any weight bearing and the progression I would take. I was very nervous that he would either say that I shouldn't start yet or that it would take months of putting a little bit of weight on it and I would still need the crutches for a few more months. But I finally got some good news. I was instructed to use a bathroom scale and start putting about 25 lbs on my foot as often as is comfortable. After a week of that, I can increase it to 50 lbs, and after one week of that, I can start trying to put all my weight on it. He said the best thing for recovery after that is walking and to try to build up to 2 hour walks every other day or so, but to make sure I start slow. So the first day maybe a 10 minute walk and then a couple days later bump it up to 15. After a month or two, I should be able to walk for 2 hours at a time every other day or so. I can't wait -- after being pretty much bed-ridden for 3 months, I just want to walk forever! I'm sure Callie will love taking long walks with me. He also said I should be back to normal as far as my foot is concerned by summer time. Then it'll just need to loose all the weight I've gained and the build back the muscle I've lost from being inactive for so long. I'm still frustrated that this process is taking so long, but I'm relieved to finally see the light at the end of the tunnel!

Thanksgiving and Physical Therapy (11/30/07)

2008-08-28T14:28:00.001-07:00

The original plan was to go to Arizona for Thanksgiving and either San Diego or South America for Christmas. But after I broke my ankle plans changed. Ira and I decided traveling for Thanksgiving with me on crutches and a broken foot would be a nightmare so we stayed in Seattle for Thanksgiving. So my parents, both having the whole week off, decided to fly up here to visit us! They came in late Monday night and on Tuesday were able to come to work with me to help me empty my mailbox (those book reps keep giving me heavy text books!) Ira had a stressful day at work on Tuesday, and I was nervous about my first physical therapy appointment the next day, so we all relaxed with a bottle of wine, cheese and crackers and other yummy snacks. Wednesday, my parents accompanied my to my PT appointment. The physical therapist was pretty optimistic about my potential recovery, but the exercises he gave me to do every 2-3 hours are pretty painful! :( Thursday, we had a very Seattle Thanksgiving. We slept in, hung out around the house, played lots of card games and then started making dinner. We had cedar planked Salmon (best way I've ever cooked salmon -- highly recommended), mashed potatoes, crab legs, a salad, asparagus, and of course pumpkin pie! After dinner, we all went to see Beowulf which was fun, but not all that impressive. I don't know how we all had room, but somehow after all that Thanksgiving food, we were all hungry for breakfast the next morning so we headed to the Kosy Country Cafe and then back home for more cards, lounging, and movies (and some nice long walks that I had to opt out of). Saturday morning, I made a pancake breakfast for everyone and then we took my parents back to the airport. All in all, it was a nice visit, though not being able to do anything active was a bit frustrating for me. Hopefully, I'll be able to start putting weight on my foot soon.

Two Months in (10/29/07)

2008-08-28T14:26:00.000-07:00

Well, it's been two months since the break and moral has been down. I still can't put any weight on my foot and have a severly limited range of motion. The scars from surgery have healed mostly -- they're still a bit tender to the touch, but they're all closed up. I've been taking the removable cast off 3x a day and tracing the alphabet with my foot per doctors orders, but I still can't seem to make letters bigger than about an inch. I don't have that knobby bone anymore on the inside of my ankle and you can feel two of the metal screws they put in through the skin -- one is so prominant you can see it if you look carefully. Also, the skin on my foot has started to resemble that of a reptile. It peels off and no matter how much I exfoliate, more flakey layers keep coming off. The bottom of the foot is the worst, though I can't take pictures from that angle by myself. I'm getting really tired of the crutches, the discomfort, and the inconvience. I don't know when I'll be able to climb again -- I don't know when I'll be able to walk again. It's hard to avoid feeling sorry for myself all the time and especially hard to be optimistic about getting my mobility back when I don't seem to be making any progress in my physical therapy. I have a doctor's apointment tomorrow -- hopefully I'll come back with good news.

Here are some pictures:

Notice the reptilian nature of the skin ...

The almost healed bruises and small inscsions and the lack of an ankle bone. If you look closely, you might see a slight prtrusion where the head of the metal pin sticks out a little.

A couple close ups of the lovely scar on top of the ankle:

Both feet for comparison. Notice how they look like the feet of two different people, differing in color, shape, size, and texture. Also notice the smooth flat surface down the inside of the left ankle where the ankle bone should be (and is in the right foot).

Also notice the difference in range of motion: pointing as far as I can and then flexing as far as I can:

And a close up of the missing ankle bone and the range of motion: pointing and flexing to my current capacity.

Wallowing in Self Pity (Written 10/5/07)

2008-08-28T14:22:00.001-07:00

When I started this blog, I never intended to use it as an online journal and I don't usually post very personal things on here. This blog was created to keep track of my adventures. But since my accident, daily activities are difficult and time-consuming and since I can barely move my foot and can't put any weight on it, adventures are out of the question. I haven't seen any of my friends since the surgery. I've been doing some research since coming home from the hospital and although the doctors say there's a fair chance I'll be able to move my ankle, right now, I can only move it about an inch. Everything I've read about this kind of surgery says that 100% recovery is very unlikely. Most people have develop arthritis, only recover about 50% of their motion, and it never holds their weight quite the same way. Removing the pins in a year or so when it's finished healing might give me more motion back, but it would probably weaken the ankle and make re-injury more likely. Plus it would require another surgery. There are people who had fewer screws than I got that can't run 3 miles anymore. Hopefully, it's just a long recovery process, but I'm starting to fear that my life will never be the same.

Off Bed-rest, stitches removed (Written 9/18/07)

2008-08-28T14:18:00.001-07:00

I finally went back into the hospital today to get my loose splint off, get my stitches removed, and to get a cast on so I can finally get off bed-rest! I have to say, almost month of not getting out of bed wasn't much fun! The pain sucked, but in the end, boredom was the worst of it. My ankle looked pretty gnarly when they removed the splint and bandages and it hurt more than I was expecting when they pulled the stitches out (12 stitches total for 4 separate incisions). And just for David, Ira took pictures (see below) They wanted me to try to move my ankle, but I couldn't do more than wiggle it a little. They decided to give me a removable splint rather than a cast so I can start physical therapy right away. And I can finally bathe as well in a couple days! Which is quite a relief because sponge baths aren't really cutting it anymore! The doctor said I can start trying to put some weight on it in 4 weeks, so I guess I'll have to get pretty used to these crutches. I'm supposed to stay home and take it easy for one more week which is quite convenient because the quarter starts next Tuesday! I'm not looking forward to limping around campus on my crutches and I'll have to figure out a clever way to get materials to and from class, but I am very much looking forward to being able to leave the house (heck, I'm looking forward to being able to get out of bed on a daily basis!). I don't think I realized before this just how debilitating a broken ankle could be, but the doctor's say it's healing nicely and they are confident I will get back all of the mobility if I'm vigilant with physical therapy. I'll be happy when this whole ordeal is behind me!

Surgery Went Well (Written 9/5/07)

2008-08-28T14:16:00.001-07:00

I was very nervous to have surgery on Tuesday, but everything went very well. The worst part was having the IV put in and that's only because I have an illogical fear of needles. But Ira did a great job distracting me and keeping me calm and just as I was drifting off to sleep, he headed for work and left my mother with me in the hospital while they operated. I barely remember him leaving and then ... nothing.

I was woken up by pressure on my right arm -- a machine was taking my blood pressure every 5 minutes. The nurse saw me waking up and came over to answer all of my questions very patiently. I got to use a bed pan for the first time (though it was something I would become *very* used to in the few hours I was there after surgery -- apparently, they pump a lot of fluids in you through the IV!).

After slowly waking up in the recovery room, they took me back to my mom who informed me that the doctors had told her there wasn't as much damage to the cartilage as they thought and it is likely I will recover fully and have full range of motion in my ankle!! I can't tell you how relieved that made me! She also told me that Ira was on his way and he got there shortly after. My mom and Ira did a great job taking care of me, including making sure I got the nurse I liked and not the nasty one to take care of me. The surgeon even poked his head in at one point to make sure I was okay and to tell me that they did the bone graft and used 3 screws to fix my ankle. He said he made a lot of small incisions instead of one large one to take care of everything (so instead of one big ugly scar, I'll have a lot of little interesting ones! LOL). He also added a refill of the pain medication I'd been on before the surgery at my request because it had been working so well. I would highly recommend Dr. Atwater to anyone in the Seattle area that needs any kind of wrist or ankle surgery. He was not only a great surgeon, but also had wonderful bedside manner. I've heard some bad things about my HMO (Group Health), but I have to say, for the most part, I think all of my medical care through them has been exceptionally good! I have had a lot of very painful moments, but I seem to have gotten a handle on how to use my medication to manage the pain and it feels good to have my foot on correctly and not wrapped in a splint at an awkward angle anymore. The ride home was pretty uncomfortable, but we returned home to see a beautiful bouquet of flowers from Ira's parents waiting for me on the front porch. I am still in awe of how kind people are being to me through all of this!

It's very frustrating not to be able to do *anything* myself, but the wounds on my hands and wrists are healing nicely so I should at least be able to wash my hair and bathe myself soon. And as soon as I'm able (6-12 months), I'll be back on the rocks! Hopefully the on-sight of Flying Circus (5.10a finger crack) will be mine next summer!! And as requested by David, I'll try to get some pictures of the carnage (and healing process) up here soon! ;)

How I broke my ankle (written 8/30/07)

2007-09-18T15:10:00.000-07:00

Well, I'm back from climbing in Squamish a couple weeks earlier than planned. On Tuesday Martha came up from Seattle to climb with me for a couple days. I'd been climbing *really* strong and was excited to see my friend and climb with her. We chose Sparrow -- a 7 pitch route to start her visit. We were going to swing pitches I took the first lead -- a run out 5.8 and I felt good on it. Martha led the next pitch (5.9), I moved the rope down a short 4th class down scramble and she took the next tricky pitch giving me a run-out 5.9 slab. I was a bit nervous and she offered to take the pitch, but I've been climbing strong lately and I thought it was time to stop handing off leads to my partners. So I took the lead. The first bolt was pretty far up and I had to traverse a bit to get to it. I was almost to the bolt and had over 20 feet of rope out when I fell and went sliding 40 feet down slab getting pretty banged up as I went. I remember knowing I was going to fall and yelling to Martha. I have no memory after that until I was passing Martha. I remember looking at at her frantically pulling in slack and then at the rope dancing all over the rock. My next thought was "Oh crap, my fingers are scrapping down the rock." Followed shortly after with the thought, "Why doesn't that hurt?" I actually felt fine when the rope finally caught me because of all of the adrenalin, but my fingers were completely bloody since I stupidly kept them on the rock the whole way down. I also had some nasty scrapes on my wrists arms and legs. And my ankle hurt a little. Once the adrenaline wore off, my ankle hurt more and more and soon I couldn't put any weight on it at all. But I still thought it was just a nasty sprain.

Martha got me down with just three lowers and she rapped down. The path getting to the bottom of the climb was rough though and we didn't know how we were going to get me out. Luckily Damien, a friend I'd met earlier in the summer and climbed with a couple times, was there about to get started on a route with a friend of his. Then one of the guys on Squamish search and rescue, Chris, showed up with his son (the kid was about 13 and he was going to take him on his first mulit-pitch route). Chris found a route that went up to the ledge we were on and rapped down with me attached to him. Difficult for him and painful to me, but I made it down. The other guys and Martha were there to carry me the rest of the way to the car. We went straight to the emergency room in Squamish where they cleaned out my cuts (this was by far the most painful part of the whole ordeal), gave me some morpheme for the pain, and took ex-rays. Turned out I had a really nasty break in my ankle requiring surgery. I didn't want to pay for it out of pocket since I'm not sure what my insurance covers in Canada, so I paid almost $800 for the emergency room care and ex-rays (ouch -- hopefully my insurance will reimburse me for at least some of it!) and left my truck up there so Martha could drive me to the emergency room in Seattle.

We got there around 11 pm and they took more ex-rays, had me fill out some paperwork and set me up for an appointment the next day with the orthopedic doctor. We finally left after 1 in the morning. Ira is out of town in Sacramento for business, so Martha took me back to her house and then back the hospital the next day so the bone doctor could look at me. Apparently I have an unusual break so several doctors looked at my ankle and ex-rays before they called in a surgeon who specializes in broken ankles and wrists. They said it's likely that I will lose 30% mobility in my ankle after it's all healed. At that point I broke down and started crying. I can handle pain and recovery time, but the idea of permanent damage -- especially damage that is likely to affect my climbing -- is heart breaking! With physical therapy, I may recover completely, but they said it's unlikely that I will recover 100%. :( Time will tell I suppose.

They scheduled my surgery for Tuesday and Ira is planning on taking the day off to get me there and back safely. Apparently my ankle bone broke off and smashed through cartilage and the bone above. They have to put that bone back where it belongs, do a bone graft, put some pins in, and then hope the cartilage heals itself. They gave me Vicodin for the pain which worked great, but wore off about 2 hours before I was supposed to take more. So I called and they prescribed Percocet for me, which my wonderful, kind, and loyal friend Martha went to pick up from the pharmacy for me. She took me to Ira's house and I'm here now waiting for him to get back from his trip this evening. I'll probably have to stay here and let my amazing boyfriend take care of me for a few weeks. The Percocet is working great and I'm comfortable, but I'm not very mobile and still upset at the prospect of losing some mobility in my ankle and nervous about my upcoming surgery. And of course a little bummed that my trip was cut short for this reason, but at least I had a great couple months of climbing before this happened! I was able to lead 3 5.10a cracks and Flying Circus will be there next year.

Throughout this whole thing I've been so impressed with how kind everyone has been. I feel so lucky to have met such helpful competent climbers in Squamish, to have good health insurance with skilled and gentle doctors, and especially such amazing loyal friends in Seattle, such a supportive concerned family, and such a caring and loving boyfriend.