And the winner is......

Not me! It turns out, I was right. I do have a stress fracture. Back in the boot for a yet-to-be-determined amount of time.
But I know you're all curious so I thought I would post an update pic. I am now 18 months out from the first surgery and 4 months out from the most recent surgery. I don't make pretty scars :) I see Dr. McGorgeous in two weeks, so keep your fingers crossed that I am somehow, someway completely healed by then!

Over/Under(reactions)

Overreaction: thinking that the instability I was feeling meant there was a new issue. After a month of careful observation, it seems that the instability comes when I reach a new level in physical therapy, hangs around for a few days, then goes away and stays away.

Underreaction: thinking that the pain on my tibia was of the same nature as the instability. Turns out it's a stress fracture. X-rays have been taken, updates will be given as necessary.

Mary Go Round

The more time passes, the more I appreciate the title of my blog. I'm giving myself a big ole pat on the back right now. To me, the title means that I just keep going around and around in the same circle. First the good news, then we'll discuss my centripetal force. The infection is dead and gone. No issues with that. I have passed my latest doctor's appointments with flying colors. I can walk to and from class. I can even take a walk on a nice day. But here's the problem. I'm STILL having instability. It started one evening when I had been sitting for awhile and then stood up. Yep, that's all it took to send me into a panic. And the official diagnosis? "Functional instability". Meaning, it feels broken, but it's not really. See also; every blog post I've written prior to this August. Because that's the diagnosis I kept getting when I mentioned the instability before. And Dr. McGorgeous was wrong on that one. It was ACTUALLY unstable. And he tightened a ligament. So, I totally respect him. And I would defend him to the death since he hasn't given up on me yet. But, I apparently have trust issues. So I don't know how to believe him now that there isn't actually something else wrong. In the meantime, the best things for me to do are to start training my ankle how to move correctly again. So, physical therapy, massage therapy, yoga. Back on the merry go round.....

On the mend?

Maybe. My infection is completely cleared up! I'm allowed to wear a shoe at work and at home (but not outside) and I'm set to start massage therapy and physical therapy again this week. Even though it feels like this recovery is taking FOREVER, my surgeon reminded me that the infection set me back a couple weeks in terms of healing. So, instead of thinking of myself as week 5 post-op, I need to think of myself as week 3 post-op. Also, the incision looks great and he was amazed at my lack of swelling. All good signs. Also, the pain I've been having isn't necessarily a bad sign. I'd describe it as an ache, and Dr. McGorgeous describes is as a "toothache you can't get rid of". It's true. I doesn't matter if I'm in the boot, in my shoe or even just sitting on the couch, there is no rhyme or reason to when the pain starts. It makes sense though. In order to fix the osteochondral fracture, he "microdrilled" down into my bone marrow. I then proceed to slowly bleed out stem cells from my bone marrow, and they fill that fracture back in and repair it. It's not a perfect technique- it won't repair my cartilage with the same type of cartilage that I originally had, but it's a hell of a lot better than just having a fracture. Anyways, the process of repairing actually causes me some pain, and might continue to cause me pain for a couple more months. Also good news- the ligament seems to be stable. He did a stress test, and it didn't hurt and I think I got an A because he didn't say I failed. This time he used a dissolving suture (so I don't reject it) and it should be completely gone in about 2 more months. I guess right now my main concern is physical therapy. I won't lie. My heart isn't in it. I have given physical therapy my ALL on three separate occassions. I don't think anybody who saw me work through the pain would argue (reminder- I worked through the pain of a foreign body reaction, scar tissue wrapped around my nerve, a torn ligament and an osteochondral fracture to my calcaneus). And I worked through that pain for a grand total of 6 months. And it didn't get me anywhere. Rationally, I know that it was because there were still injuries. But, there could STILL be injuries now! How do I psych myself up to deal with the pain and the effort when there have never been any physical rewards for going through it in the past? I can't quit. I know that and there's 0% chance that quitting will happen. Hopefully when (if?) I start to feel some progress, the attitude will follow.

Quaratine!

So after being informed that I was headed to the hospital, I was told to go home, pack a bag and wait for a phone call to tell me what floor to go to. Instead, I packed a bag, unloaded and loaded the dishwasher, watered my plants, turned in my homework and went back to work. By the time I finished telling my boss what was happening, it was time to go. I found my floor and the nurse took me to my room. As I passed each room I could see that everyone seemed to be elderly. These were some very sick people. And they also appeared to be sharing rooms. I was not too excited about this. But, my room was empty when I got there, and only contained one bed! This, I learned, is because I was being quarantined until I learned whether or not I had MRSA. Fine with me! I got set up with a hospital gown and the remote to the TV (which gets better cable than I do at my apartment) and nobody came back for over an hour. It was amazing. As bad as I felt, and as hard as I had been pushing myself since the surgery, just resting in bed felt incredible. After an hour, the hilarity began. The first 2 people to enter my room were a student nurse and her instructor. The instructor asked if the student could start my IV. I hesitated and the student said "I know what you're going to ask, and I have started one before". I reluctantly agreed, but warned her that my veins are deeper than they look. They both looked for a vein for about 10 minutes as I felt the cold sweat of fear starting to drip. They eventually decided that my deep veins were a job best left to a pro :) Bullet dodged. So now I've been in the hospital for an hour and a half, an IV started, and no bracelet. With as much experience as I have as a patient, I am always on the lookout for ways that medical errors can be avoided. So I ask for a bracelet. And although I assured I will get one, another half hour passes without any identification on me. Then the lab tech shows up to get blood. She's about to start drawing blood and asks to see my bracelet. I explain that I still haven't gotten one. She asked how long I had been there, and I told her two hours, and she flew out of the room and I had a bracelet within the minute. So with the blood sucking vampires satisfied, I get to order dinner (the stir-fry is disgusting, go with the pork loin) and rest and visit with friends. At 10pm, my first dose of antibiotics arrives, and with it, a shot of Heparin. A blood thinner. So I don't get a clot in my leg. I express my disbelief that my 27 year old, non-smoking, non-birth control taking legs are going to clot, especially because the Heparin is injected into your stomach every 8 hours, but I feel too tired to fight this very much. Nighttime is terrible in the hospital. My IV pump is noisy. I'm awake to check my vitals at midnight and 4am. My next dose of antibiotics are at 6am, so I'm up for that too. And I'm up all morning. By the time my disgusting lunch order shows up and it's missing cheese, I'm in tears. I was just SO TIRED. One of the several wonderful nurses I had told me about a little thing they have called EARPLUGS. I slept from 1-5. Dinner, friends, TV, antibiotics, earplugs and sleep again. The next morning, my surgeon shows up around 6:30am. He tells me it's NOT MRSA, and asks what I want to do. I believe my response was "GET ME OUT OF HERE!" So just like that, my vacation, I mean, hospitalization ended. I walked out of there with a new prescription for oral antibiotics and went home to sleep away Labor Day weekend.

The Gift That Keeps on Giving

So as you all know, this was my 6th surgical procedure. To say that I have some practice in surgical incisions is an understatement. Generally, my instructions are to keep it clean and dry and change the dressings twice a day. I use dressing-changing time to monitor for any signs of infection. Last Monday night I changed my dressing and went to bed. All was well in the ankle world. Since I changed the dressing immediately before bed on Monday, I did not change it first thing Tuesday morning. I noticed that I had some increased pain, but my pain had been increasing for a few days and I attributed that to overdoing it. By lunchtime on Tuesday, I was VERY uncomfortable. I had lunch with a friend, and told her I thought the bandages had bunched up under my boot, and I needed to straighten them out. I un-booted myself and as I unwrapped the gauze it became clear that the friction I had been feeling was not from the bandages, but from a large lump of rock-hard swelling. And to top it off, my incision had turned a beautiful shade of Barbie hot-pink. I proceeded to stare at it dumbfounded. Not because I didn't know what this meant, but because I DID know what this meant. And I could not believe that after 5 previous successful surgeries, my background in biology, and the fact that the incision was almost 3 weeks old, that I had become infected. I was almost in denial about it. I was hesitant to call the doctor because I truly thought there HAD to be another explanation, and that in an hour or two, things would return to the way they had looked just a few hours prior when I had changed my bandages. My disbelief eventually wore off, and I called the doctor's office, who called me in a prescription for antibiotics, sight unseen. I had a regular post-op appointment scheduled for Thursday, so the plan was to get two days of antibiotics in and reassess then. I spent all day Wednesday and Thursday morning sweating and feverish at work. My incision did not look better and I felt worse. My appointment Thursday was scheduled with the nurse, and I called that morning to see if Dr. McGorgeous could sneak me in to take a look. Since Thursdays are OR days for him, he was booked solid. At my appointment the nurse was very nonchalant. She was able to squeeze my incision hard enough to get a sample to culture. I will not go into detail on the amount of pain that entailed. Just imagine someone grabbing your fresh incision and squeezing. Hard. I was concerned that after 48 hours of antibiotics I was actually feeling worse. She said that was normal and I should just go home and wait for the culture results. I wasn't pleased with this, but I had decided that if she didn't take this seriously, I could always just go to the ER. As we were wrapping things up, there was a knock on the door, and Dr. McGorgeous walked in. I have no idea how he knew I was there, or what made him decide to come over from the surgical center, but there he was. He looked at my ankle, listened to what I had been feeling and the first words out of his mouth were "I'm sticking you in the hospital". He continued with "Don't be offended, but based on your history, I'd rather be safe than sorry". So began my first hospital admittance since birth.
To be continued....

Changes and Surprises

You might notice a couple of changes on my blog. I decided I needed a better description. I want people to be able to find me if they are searching for ankle blogs. The other big change is that I had to edit my surgery on August 12th. I went for my first post-op appointment this week and found that I had a much bigger surgery than I originally thought! When Dr. McGorgeous went in, he found that my lateral talocalcaneal ligament was lax and I had an osteochondral fracture on the underside of my talus. Ok, picture it like this. You have two blocks. One on top of the other. The bottom block is your heel, your calcaneus. The top block is your ankle, your talus. Normally, a ligament holds them every so slightly apart. My ligament was torn, so nothing was holding them apart, and with every step my ankle bone was grinding into my heel bone. The ligament has been torn since the beginning, January 13th of 2009. I'm not sure if the fracture happened at that time also, or if it formed over time from the constant grinding. Regardless, they are now repaired. My feelings on this range from sheer gloating (Ha! I TOLD you it felt unstable!) to joy (maybe this was the last surgery!) to anger (why the hell didn't we find this sooner?!) to panic (how the hell am I going to find time to rehab this??) to fear (maybe this wasn't the last surgery). I'm all over the place. At any given moment I am any combination of these feelings. Physically, I'm still really tired. I'm trying to take is easy, but in reality, I'm not. Between work and school I'm putting in 12 hour days. Not anything to write home about when you're healthy, but when you're 10 days out from major surgery, it's not ideal. What else? Oh, I'm in my boot. And it's hot. And heavy. In August. Whine. I'm still in pain, but I'm trying very hard not to panic about it. After all, I still have my stitches in. If it's not even healed enough to take out threads, it's probably not healed enough to stop hurting, right? RIGHT!?!??!??! So, what's next for me? Well, today involves an afternoon of elevating my ankle. Possibly a pain pill. Next week is getting the sutures out. Week after that, physical therapy starts again. Here we go!

Clean and Sober

Today was my first day without drugs and my first shower since the surgery. I no longer feel like I was hit by a bus, but I am starting to get antsy and stir crazy! Even more impressive, I was able to start walking already, although I don't know how much PT, if any, I'll need. This surgery is not like the original ligament repair. That one took me 5 weeks to walk on, but this surgery only took a couple days. Dr. McGorgeous swore I would be able to walk the DAY OF surgery, but I woke up and took one look at it in all its swollen, misshapen glory, and knew I would never squeeze it into the boot. So, the boot stayed off and I used the crutches. And it's a good thing I'm so damn smart, because when I did try walking, I had some definite issues with swelling. I ended up loosening my bandages twice to relieve some of the pain, which I didn't have to do in the 5 previous surgeries.
So, I posted the surgery game plan in a previous blog entry, and I'll just update you on what they found. Apparently, my talus had started turning in on itself and as soon as the bone abnormalities were removed, it corrected its positioning. I'll probably have to wear an insert in that shoe for awhile just to be on the safe side. Also, I may or may not have had a dissolving suture put in that subtalar ligament. A couple things got lost in translation between Dr. McGorgeous and MaryGoMom. I will clear everything up at my first post-op appointment. Also, I can't unwrap my ankle yet, so I have no idea what the new incision looks like! Waiting another 8 days to see it is like, the worst Christmas present ever!!!! I am going to tryyyyyyyy to be patient, but I might need just a little sneak peek!

The latest

Results are in. The CT scan showed what I expected.

Don't get me wrong. I don't consider myself a pessimist. I don't THINK bad things are going to happen to me. But I do think that I know how my body feels. And I think I know when it's bad enough that it requires surgical intervention.

Now is one of those times. So I have officially reached the point where my ankle is un-google-able. WebMD doesn't have a clue. That's intense. I think I should buy a lottery ticket.

Dr. McGorgeous came in today and hadn't read the CT scan yet. He said he didn't want to cheat. So we looked at it together. It was fascinating to watch his game plan change with each picture that appeared. I wish I knew what he knew. The first few pictures showed a several bone spurs of varying intensity. To the point of looking pre-arthritic. Uhhhh, I never thought I'd be discussing arthritis at 26. Turns out, that would be the high point of the appointment. From there we saw more and more bony abnormalities. The plan turned to an arthroscopic surgery. Then we saw The Big One. The mother of all bony abnormalities. It turns out, the abnormalities are causing my joint not to move together correctly, which is why it feels so unstable. The Big One is so big that we decided the best course of action would be to forgo the arthroscopy and open up the joint completely. I'm actually really happy with this. I think the doctor will have a better idea of what's going on by opening it all the way up. I also think back to the meltdown I had after the diagnostic ultrasound. The one that showed there was nothing wrong with me. When there is nothing wrong with you, there is nothing to fix. This CT scan didn't show great things, but it gives us a game plan, and something to work on. I know I'm supposed to be upset that I need to have surgery, but honestly, I was more upset at being in pain for "no reason". So I am now scheduled for my 6th surgery in 15 months. I feel good about this. Each surgery has given me a little bit of my old life back. I can accept now that I'm never going to be that person again, physically or emotionally, but I know that I have the capability of getting to a really good, maybe even better place than I used to be. I can't express my gratitude for having a surgeon who didn't give up on me and send me to Pain Management when I truly had fixable problems. It's not lost on me that for every person like me who gets the intervention they need, there are many more who end up lost in the pain management shuffle. I could very easily be a person who spends the rest of their life on painkillers, and continues to give up all the parts of life I've given up for the last 19 months. I don't know why I wasn't put in that group, but I think the part of me that changed mentally knows that I have an obligation, forever, to make the most of that.

I missed you!

It's true, I did! But I needed a little break to kind of step back and see where I am. Sometimes when you talk about every single minute detail you miss the big picture. I didn't want to miss the big picture. So wanna know what's up? Well, the good news is that I've seen some improvement. I go to yoga once a week and do what everyone else does, except anything that involves standing on one foot. I can walk a couple of miles. I can even walk on uneven ground. I don't need the TENS unit anymore. That's where things start to get interesting. The TENS unit made it so ridiculously obviously clear what was nerve pain and what was not nerve pain. The TENS got rid of that achy dull constant pain. Honestly, I don't even have that anymore! That's what is allowing me to be more active. The problem is a different kind of pain. A sharp pain, and....wait for it....an unstable feeling. It feels like the bones are not sitting in the joint correctly. And the TENS won't touch that feeling or that pain. And this type of pain is predictable. It occurs AFTER any activity. Seriously. Not during the activity. I'm fine. But I know once I stop and begin to relax that it will happen and last at least 18 hours.
Sooooo, I saw Dr. McGorgeous this morning. And I knew going in that I was going to be VERY FIRM about this instability. I wasn't going to hear anything else about crappy nerve pain. So the first thing he tells me is that it might be nerve pain. Sigh. It's possibly that my brain is just so seriously confused about where my ankle is and what it's doing that it can't tell it to behave correctly. Then he tells me that there's another option. An injury that occurs very rarely. And we both start laughing at that. Because if anyone is going to have a rare injury, it's me. I'm sure you're wondering about this rare injury. It's a torn ligament. In the subtalar joint. Yes, you read that correctly. There's a possibility that each and every day of the last 18 months, I have had a second torn ligament. So where do we go from here? To the CT machine, of course. I'm currently waiting on pre-authorization from the insurance company and to get an appointment at the hospital.

Updates soon!!

"You've turned the corner"

Those were the parting words my surgeon left me with this week. I've been dying to post an update, but first I wanted to hear from him. The TENS unit I've been sporting for the last few weeks has been a game-changer. Although I wear it 80% of the time I'm awake, I immediately started to notice that the 20% of my time without it had significant reductions in quantity and quality of pain. Friday night was an eye opener. I was crossing the street after dark, and as I was halfway across the street, cars appeared from out of nowhere. I had to run 6-7 steps to make it out of the street and avoid become a road pancake. And those 6-7 steps were completely pain free. Which got me thinking.....
The next day I spent wandering around nature taking the pictures you see here. Uneven ground has been notoriously pain inducing for me.
Sunday I went for a two mile walk.
Monday was a 1.75 mile walk.
Tonight was YOGA!!!!!
While I am not 100% cured and I do still have pain and a long road to get my strength and conditioning to where it was a year and a half ago, I've turned the corner.

Recharged.....

Hahahahahaah, I'm so hilarious. The blog title is funny because 1. I'm actually feeling better after my short bout with addiction. And 2. because I'm currently in possession of/hooked up to my TENS unit. What's a TENS unit? Good question, readers. According to wikipedia, a TENS unit is a Transcutaneous Electrical Nerve Stimulation Unit and works by "activation of opioid receptors in the central nervous system". Of course, wikipedia also says "TENS units are used by the BDSM community for erotic play involving electrical stimulation." So take that with a grain of salt. Yikes. Anywho, today is day 1 of using the TENS unit. It's bizarre. You know how when your foot falls asleep for like, a REALLY long time, and then it wakes up and it's THE WORST FREAKING PINS AND NEEDLES EVER!? Yeah, it's like that, for 4 hours at a time. Then I get a one hour break. Let me clarify. I am not complaining. It is a better sensation than pain. However, it is WEIRD. And will require some getting used to. Also, I don't think I can walk through the rain anymore. So those electrodes stick to my leg and foot and the wires attach to a small battery pack that I can clip on my pants. If I run the wires under my pants, you can't even see that I'm wearing it. I also had some ultrasound therapy done at PT this morning. It didn't really feel like anything. I thought it was supposed to get warm but it didn't. Speaking of PT, this morning was my first land therapy session. I didn't do much because of the TENS unit explanation and the ultrasound, but I did do a warm up on a bike and a short stretch. Then a little bit of strength and a bunch of balance work. I was SERIOUSLY impressed with my ability to balance. And on an even more positive note, whether it's from the TENS or the ultrasound, there's been no pain today. Just weirdness. Keep your fingers crossed for me.

Happy 1 Year!

A year ago today I had my first surgery. In honor of that, I've written a Haiku:

A year has passed now
Still cuter than a cankle
but not like before

Looking good!

Pretty? I'll update soon...I've got some things in the works...

If I Could Say Anything.....

Dear Dr. McGorgeous,

Because our time is limited to an office visit once a month and a handful of surgeries (which don't count since I'm sedated), I'm writing this to help you understand, as a doctor, what happens when you leave the room and literally and figuratively wash your hands of me each month. When I leave, I limp up to the receptionist and set up my next appointment. I wonder when I won't have to do this anymore. Strangers overhear me talking about needing to see a Rheumatologist and ask me whether or not I'm even in my 30s yet. I limp out to my car and wonder if I'm ever EVER going to stop hurting. I drive back to work. Did you know I'm supposed to be a surgeon? It's true. I've wanted to be a doctor since I was in 5th grade. For the last 15 years, when I've imagined this scenario, I was the one in the white coat, not the one laying on the exam table. Did you know I had to put medical school on hold? Do you know that it kills me to have done that? I made it so far......through college, through activities, through volunteering, through research. I was in the middle of studying for the MCAT when I got hurt. Did you know that? That time is ticking away on my ability to make this dream happen, and I can't and WON'T keep going with it right now. I wouldn't trust me as my surgeon. I wouldn't be able to make it through a 30 minute surgery without being distracted by my own pain and I can't in good conscience subject people to potential errors because of my distraction. Did you know that I think about this when I have a bad day at work? How much I'd rather be scrubbing in on a surgery than doing my current job? When I first decided to become a doctor, I wanted to be a pediatric cardiologist. This was also before I knew what a residency was. I've jumped around from specialty to specialty over the last decade and a half, but now I doubt I'll ever get the chance to do it at all. I wonder how something as stupid as an ankle could ruin almost everything I've ever worked towards. I think about the friendships I've lost and ended because people can't or won't be supportive. I feel sorry for the friends who remain because they're stuck with me. And don't get me wrong, the pain hurts, but every once in awhile I'll catch a glimpse of my ankle and that hurts too because it reminds me that I'm scarred for life. I'm too tired of this to be vain anymore. I don't care that you've cut and re-cut me. I care that if I choose to expose my leg, I'm inviting stares and questions from total strangers. I wore a dress to a wedding last week and I had to talk about it all night. I lay in bed at night and sometimes I can't sleep because of pain. Sometimes I can't sleep because of stress. Sometimes I can't sleep because I've had a really good day and I start thinking about all of the yoga I'm going to do, and walks I'm going to go on, and high heels I'm going to wear when this is all over. I take the pills you tell me to even though I hate pills. Did you know that before I was hurt, I wouldn't even take a tylenol for a headache? And now I own a pill organizer because there's too many not to confuse. So this is what happens after you leave the room. I would never say that you don't treat me like a human being. Actually, you have the best bedside manner of any doctor I've ever had. I just don't know if you really realize just how far this reaches into my life. And I want you to. I want you to understand my urgency, and my frustration, and my anger at no one in particular. Why I'm fighting so damn hard every day. And I'm scared ALL THE TIME that you're going to walk in one day and tell me you've done all you can for me. I need you to keep fighting this too. I hope you understand.

:o

I just went back and read what I wrote last night. Holy.Pity.Party. While that is actually how I felt last night, it probably isn't the best representation of how I feel in general. Yikes.

Can we be serious for a minute?

I have been dreading this blog post for awhile. DREADING. It's taken me this long to wrap my (currently very fragile) mind around what's happened and get to a place where I want to talk about it. Actually, that's a total lie. I don't want to talk about this at all. So I'm writing this post the same way little kids do their homework. I went for my ankle ultrasound. And they found nothing. There's nothing wrong in there. I just hurt. After a year and a half they can't find any reason for my pain. And to be totally honest, this really feels like the end. The final, official, life is never going to get better end. And I don't know why. I don't know why I have to live like this. I want my old life back so bad. I can't do a whole lot without crying anymore. I don't know where I can go from here. I've exhausted modern medicine. And the prospect of another 50 years of this makes me sick.

It was the best of times, it was the worst of times...

IDK what the title is all about. I just feel like I need a big strong opening, because I'm gonna drop some knowledge on you. How weird is it that I'm actually scared to write this? There's a new one. And also, the reason I feel like I can get through this post is because I'm on drugs. Lets start at the beginning, use small words, and avoid shiny objects for the crazy lady (that would be me). I've told you all about the crazy prescription. That makes me crazy. CRAZYCAKES. Anyway, my last pill was Saturday at lunch. And all the villagers rejoiced! Until Saturday night when I had a really hard time falling asleep and my back hurt. And then Sunday when I was extremely agitated, aching, and exhausted from not sleeping. Then Sunday night when I couldn't sleep again. At work on Monday, my pulse was racing, my heart felt like it was going to beat through my chest, my palms were sweaty, I was shaking, I hurt all over, and I was full of rage. I was pacing the halls like a caged animal. Fortunately, I had a checkup with the surgeon in the afternoon. He came in and asked how I was, and I asked him if it was possible for people to go through withdrawals from the crazy medication. And he looked me in the eye and said he'd never seen anyone do it before, but I was clearly doing it now. I kind of started crying a little. Dr. McGorgeous was so good about it. He said that my brain became dependent on the drug, even though I didn't like how I felt on it. And I was going through a withdrawal just like for any other drugs. He told me that he knew I just wasn't myself, and his number one concern was ending this episode. He tossed around the idea of putting me back on the crazy meds just to wean me off, but I was worried that the medicine makes me feel so bad, and I'd already put three days into the withdrawal, maybe I should just stick it out. He wrote me out a couple new prescriptions to help the agitation and insomnia, and promised to call his drug rep to find out if there was anything different we should be doing. Sigh. And this is all before we even start talking about the pain. Because I'm the most helpful patient to ever exist, I took the liberty of drawing lines on my ankle wherever I felt pain, so when I rolled my jeans up, he had a working map of my pain. Now, a lot of this part of the visit is very fuzzy, or I'm missing pieces altogether. But the first thing we are going to do is ultrasound my ankle to get a better look at the soft tissue. This will help us decide the next move. I may be having tendon problems or I may be having nerve problems, which will take me to Pain Management. Despite being told that Pain Management doesn't mean drugging me senseless for the next 50 years, I have a sneaking suspicion that it does. I can't worry about it yet though. Mostly because these new drugs don't let me have feelings. I am nothing if not mellow. So I'm getting my ankle-baby ultrasounded tomorrow morning, and that will lead us in some direction. The good news is that Dr. BlueEyes is doing the ultrasound, so I get to see an old friend and fill him in on what the last 15 months has brought me. So stay tuned faithful readers.....tomorrow is a big day.

High and Lows

So one of the issues I have with life in general is that it keeps moving. It would have been super-nice if for the last year and a half, time had stood still while I dealt with this. But, unfortunately, I seem to have misplaced the giant Pause button that stops life. So in the meantime, I go to work, and brush my teeth, and buy purses and coffee filters. And manage friendships and move from one apartment to the next. In other words, I have my life to live. And life after this last surgery is no exception. I'm back at work, and grocery shopping, and doing my laundry, etc. But some of the main problems I'm having are the side effects from the drugs. One of them has the most ridiculous side effects. On one hand, it's horrifying, but on the other hand, it has created some AWESOME hilarity in chronic pain stories. Example 1: Inability to talk. No kidding. For about an hour after I take the pill (which I do three times a day) I lose my ability to speak. I think thoughts in my head, but they get lost on their way out of my mouth. Example 2: Forgetfulness. And not your run of the mill, did I turn the coffeemaker off, forgetfulness. Like, missing chunks of time, putting the car in reverse instead of drive, forgetfulness. Example 3: Inability to walk when mixed with painkillers. I started physical therapy on Wednesday (we'll get to that in a minute) and took my first painkiller since day 7 post-op. When I wasn't taking this crazy prescription. I took the painkiller before bed and tried to get up in the middle of the night to see why the neighbors were making so much noise. And I fell down. And took most of the things on a shelf with me. When I woke up in the morning, I wasn't even sure if that had really happened (see Ex. 2) until I looked over to see my stuff EVERYWHERE and a huge scratch in the wall. Oh well. It's a rental. SO! Lets get to the good stuff. Physical therapy. AQUATIC therapy, to be specific. Love. It was amazing. I'm kind of a know-it-all when it comes to PT because I've done 16 weeks of it on my ankle already. But I have never done anything in the pool before. It was great to feel so buoyant, and be able to do squats and calf raises on the very first day. I was getting some cardio going by pedaling my legs in the deep end for 15 minutes, and I got the most awesome endorphin rush! I was giggling to myself in the water from all those feel-good chemicals! And at the end of my session, the physical therapist turned on the jets in the pool and it became my own private hot tub. I was required by my physician to sit on a bench and let warm jetted water massage my leg. I may or may not have positioned myself so that my back was directly in front of a jet also. Hey, I gotta make the best out of this! I will say that about an hour later the pain was pretty all-consuming (hence the painkiller before bed) but the next day I felt good. Sore, but like I used my muscles sore. It's a feeling I have missed. So at this point, I'm waiting. Waiting to get off these drugs and waiting to see how my ankle responds to the physical therapy. Waiting to see if the scar tissue returns. Waiting to see if life will pause itself til I get better. Waiting to see if I ever will get better. Waiting to stop waiting!

I-N-D-E-P-E-N-D-E-N-T do you know what that means?

It means I can walk! Woot! So let me fill all of you in on what has happened this week. I'm back at my apartment, up 17 stairs to my bedroom. My GINORMOUS arm bruise is healing, although still ugly after two weeks. What else is there? Oh yeah. So my ankle. I went to the doctor on Monday, and he didn't even show up to my appointment. Some lousy excuse about "emergency surgery" and whatnot. Him not being there just meant that I needed to take control of the appointment. I know what we had discussed last week, so I informed the nurse that she needed to order my bloodwork (a full Rheumatoid Panel), start me on steroids (RAAAAAWWWWRR), get a prescription written for physical therapy in the water, and have my stitches taken out. I also told her I would be starting a calcium and vitamin D regimen. Since I wasn't really giving her options here, she paged the doctor and verified everything, so I was good to go. Oh, and the stitches coming out? Which had been a panic attack inducing thought for the last year? It was no big thang. She probably took out about 15 sutures, and there were 2 or 3 that just didn't look ready to come out. They are dissolving, so it doesn't really matter that they are there. We were chatting the entire time. I don't know what kind of butcher they sent in last year, but I no longer fear suture removal. This is a good thing. Perhaps I'll stop taking my own stitches out now. Maybe. So after I was de-stitched, I had to go to ANOTHER facility to get my blood work done. Lame. But the cute guy who took my blood and patiently listened to my story about how this was the place I had come the first time I was diagnosed with a sprained ankle told me that now that I have a boot I should wander around and put it up someone's rear end for the way I was treated. Thanks for the laugh Cute Blood Taking Boy. After that was over, I had to go pick up my steroids from the pharmacy. Came home, removed boot and proceed to take a few steps boot-less. I'm "transitioning out of the boot". Meaning, I wear some kind of support (from my wide array of fashionable ankle braces) when I leave the house, but inside I go free as a bird. Other things you should know: I had my first physical therapy appointment (well, for this round of PT) this morning, I took 12 pills (!) yesterday, and I'm currently going back and forth between being so tired that I fall asleep in inappropriate places to so wired that I sweat like crazy, my heart rate increases and my blood pressure goes up and I wake up at 4:45 in the morning. And also consume twenty 8oz glasses of water a day. But these are all stories for a different day. Stay tuned!

Because I'm an Attention Whore...

I just took my first steps. No crutches. :)

Tiny Tim

Today has been a good day. I'm walking (limping? crutching? idk) on one crutch right now. This is such a huge step (lol) for me mentally. Whereas yesterday I could actually see myself confined to a wheelchair for all eternity, today I can picture myself as independently mobile. I'm now taking a 10 day course of Lyrica, which is normally a fibromyalgia medication. When the surgeon took the rope of scar tissue off of my nerve, the nerve got pissed, and understandably so. So yesterday was my first day of trying to put any weight on that foot, and I noticed some nerve issues starting. The ball of my foot feels like it fell asleep, and it feels like that constantly. Occasionally that feeling moves around to other places in my ankle. I called the doctor and spoke to the nurse, but we all knew this was a possibility from the beginning. While I'm not overly thrilled at having to take Lyrica, due to it's crazy side effects (1 in 500 people notice severe depression/suicidal thoughts), I know that this nerve damage can be permanent if we don't nip this in the bud. So the Lyrica is supposed to calm this nerve down. Today I've noticed that while the feeling is still there, it has diminished. I can also add another "pain" to the list of body tissue I'm aware of. I can now distinguish between ligament, tendon, muscle, fascia, bone, and nerve pain. I credit my massage therapist for this. With his help I have become very aware of what I am feeling, and I can then translate this to the surgeon. Way to go Team! I also haven't needed any pain medication so far today, which feels great. I have now brushed my teeth for three consecutive days. Major turning point. I still can't understand how people (myself included) have the energy to shower daily, but I'm working my way back there. I'm also focusing on doing my range of motion exercises on the ankle. The more I can keep it moving, hopefully the less scar tissue that forms. Last night I wore my elderly person compression sock for a few hours. This is also supposed to help calm that nerve down. All in all, I feel like I'm right on track.
"God bless us, every one"

Deja Vu

So I'm in the process of learning how to walk again. I went back and read the previous post I had done about it, and I realized something. There is NOTHING funny about this at the moment it is happening. Apparently, my humor only appears in hindsight? So bear with me here, because I am not currently feeling hilarious. I spent today with my boot on, but still using the crutches to carry 90% of my weight. I remember panicking last time and thinking I would never walk again. So I'm while I am, in fact, panicking that I'll never walk again, I'm not mad at myself for panicking. Ha! Does that even make any sense? I guess the good news here is that the pain and fear are taking up a lot of the space in my brain that had been devoted to worrying about Rheumatoid Arthritis. You should all be grateful that I didn't try writing earlier. Before I showered, it had been 5 (yep, seriously) days since my last shower. I was stuck on the couch, eating apples and watching Martha Stewart. That was seriously the peak of my post-surgical depression, so far. I hope that was the worst of it! That's not something I would normally talk about (the depression part, I mean. I laughed about the Martha Stewart part with everyone) but for some reason I feel compelled to share this process in its entirety. Yes, I am a truly hilarious human with what I feel is a generally good attitude towards everything (including myself, apparently!). BUT. I've also been in pain every day for over 15 months. I've gone through 5 surgeries. I've been worn down and given up and lost friends. I would be doing the universe a disservice if I at any point implied that this was easy. I wake up every day and feel like I'm preparing for battle. Today I don't have any "moral of the story" advice. I'm not desperately looking for the light at the end of the tunnel. Today is just a day to be. It is what it is, and I've just about survived it. Maybe tomorrow will be different. And maybe it won't. There aren't any guarantees with this.

What I've Learned

I suppose I should post another update. I mean, sitting here with my leg elevated is super time consuming, but I'll do it because I love you. I showered today. For the first time since Tuesday morning. I'm not even the slightest bit ashamed of that. Drugged up me + balancing on one leg + slippery wet shower = DISASTER. So today I was able to cut down on the drug use long enough to get clean. (hahahaha, get it? get "clean"?) I even managed to put on clean clothes (yes, I was in the same shorts and t-shirt from Tuesday). I'm actually really surprised at this recovery. Maybe I've just done this enough times now, but I'm getting REALLY good at this! My leaking, drooping, sagging ziploc bag of ice has been replaced with a refreezable cold pack that velcros in place. The metal folding chair in the shower has been replaced with a homemade bench. The broken garbage can I rested my leg on while I peed has been replaced with the same sturdy bench. These upgrades may seem silly to you, but that's just because you don't have a clue. :) Seriously though, come talk to me when your life involves emailing your immediate family to tell them that you managed to poop after 3 days instead of 11. Oh yeah.......I was pretty proud of that. Prunes, baby. I live a pretty shameless existence. I don't have too many complaints at this point. Yes, I hurt, and my incisions are starting to itch. My hands are sore from the crutches. But honestly, I'm really reluctant to make those complaints. This is much, much easier than what I was expecting. I guess I'm just waiting for the other shoe to drop....
BAHAHAHAHAHAHAHAHAHA, puns are funny!
Since I'm not in a cast, I'm trying to move my ankle a little bit every day. I can see that my calf has shrunk, but today I was able to move my foot to almost 90 degrees! This is good, because Monday morning I'm going to have to get my ankle into The Boot, and it will need to be at 90 degrees to do that. The other good thing about my leg shrinking is that now I can peek under the bandages. Not for the faint of heart, but I'm the girl who made the surgeon give me a jar with my suture and chunks of scar tissue. I'M not for the faint of heart! If I could just get that nagging idea of Rheumatoid Arthritis out of my head, I would be a happy girl right now. Speaking of The Boot. I now have a matching set. I pretty much wore the other one to the ground. Considering I've worn it for 3 of the last 11 months, it's had about all it can handle. I got a new one, and it's most definitely The Boot 2.0. It's smaller, lighter, more streamlined. And now that I have two Boots and can theoretically wear them as a pair, I have an Official Most Expensive Pair of Shoes, ever. Coming in at a grand total of $1800.00. So your Manolos can eat it!

Made it!

Yesterday was the big day. Surgery #5. In some ways I was more nervous about this one than the previous 4. Not the same kind of nervous I used to get....will I wake up, will it hurt, what will the recovery be like? I've done this enough to know the answers to those questions. This wasn't fear of the unknown. This was fear of the known. I know EXACTLY how much I have at stake here. My day started pretty early. As in 4:45am. I woke up from a dream where I knew it was the morning of surgery, and I was eating breakfast. And halfway through eating my breakfast, I FREAK OUT because you're not allowed to eat that close to surgery. So I totally consider lying to the doctors and nurses and not telling them....and then I woke up. If anyone has any ideas what that dream means, feel free to share, I'm stumped. Not. So after waking up and NOT eating breakfast, I arrived at 9am. Unfortunately, Dr. McGorgeous was running behind schedule, so instead of starting my surgery at 10am, I didn't get taken back til about 11:45am. In that time, I managed to charm Dr. Grinch into providing me an adequate amount of anti-nausea drugs, as well as have so much of my IV drip into me that I needed to go to the bathroom in my gown, carrying my IV bag. I've told you guys before, dignity isn't really an option. So in addition to having that stupid suture removed, I also had my ankle scoped out to remove scar tissue and inflammation and my anterior compartment explored. Oh! AND I had a 4th PRP treatment. Because at this point, why not? Lets just throw every technique known to Foot and Ankle surgeons at this thing and see what sticks. In the extremely wise words of myself to Dr. McGorgeous "Just.Cut.Everything". The PRP this time was a little sketchy. The tube to collect blood in didn't seem to have any vacuum in it, so the nurse had to poke around a lot. I've included a picture for your enjoyment! So I get wheeled back to surgery, and they inject the stuff that killed Michael Jackson. It burns going in, like A LOT. They gave me oxygen again, only this time it didn't cause me to react with ANGER AND RAGE. The mask was slipping off, so I actually reached up and held it over my face for awhile. I'm such an angel. Then I woke up in recovery. And I didn't feel good. It's probably the most pain I've woken up in yet. The nurse gave me some drugs and brought my crackers. I politely tried to explain to her that I wasn't trying to throw a tantrum again, but at that very moment I hurt too bad to eat those. I'm adorable. She goes to get more drugs, and at this point I realize I have something on my head. So I reach up and pull off a towel. WTF? She comes back and sees me staring at this towel and asks if I'm warm now. Um, yeah? Was I ever NOT warm? Apparently. She tells me I woke up freezing cold. So now I know that I FOR SURE talk under the affects of anesthesia, and I now have to live my life knowing I've almost certainly hit on Dr. McGorgeous. After eating crackers and drugs, dressing myself and peeing, they cut me loose, and my mom drives me up to my parent's house where I'm recovering. Along the way my mom explains to me what the doctor found. First of all, he found excessive amounts of inflammation and scar tissue. Like, a surprising amount. So much that he said my ankle looked just as bad, if not worse, than it did a year ago before he fixed it! And I've seen the scar tissue, because he put some chunks of it, along with the stupid suture in a jar for me to keep. We had planned to start me on anti-inflammatories for about a month anyway, but after seeing the chaos and destruction my immune system is capable of, he's now including steroids in this regimen. So if I go all roid rage on you, you'll know why. He also didn't put me in a cast. I woke up wrapped in gauze and an ace bandage. I'm not allowed to walk on it, but he wants me to start moving it immediately. The last, and quite possibly most scary thing he said was that the amount of inflammation I was producing had two possible causes. One, just my body's response to the suture. Two, I have the auto-immune disorder called Rheumatoid Arthritis, and he's sending me to have a specialist to have bloodwork done to rule that out. RA is debilitating disease, so it's a little frightening to hear that. My appointment with the Rheumatologist isn't for a month, so let's worry about other things until then, shall we? So right this very minute, I'm just keeping myself drugged, iced and elevated.
SPOILER ALERT SPOILER ALERT SPOILER ALERT
In my next post I will tell you how all the tips and tricks I've learned along the way have made this the smoothest, most dignified recovery I've had to date!

Sunshine

Today I had an appointment with my surgeon. See, this is what I love about having told you guys the whole story. Now I can just tell you about my day! So, I saw Dr. McGorgeous today. He came in, and I started to tell him "I just wanted to talk to you. I need some reassurance about this next surgery. The past few weeks I've been....." and I just kinda trailed off. But no worries. Dr. McGorgeous chimed right in with "Going a little crazy?"
DON'T MIND IF I DO!!!!!
Anyway, yes, I've been stressed because I just wasn't sure if the surgery is the right thing to do, and if it is, I need more details on what's going to happen. So he goes "Would you be willing to try something". Now, anyone who knows me can tell you that I love to experiment. It's why I went into science. And the only thing I love more than experimenting, is experimenting on myself. It's terrible, I know. Call my IRB. So without even knowing what I'm agreeing to, I agree to whatever he wants. I iz smart? Anyway, his suggestion is to inject the soft tissue around that craptastic suture with a numbing medicine. If that takes the pain away, then we know that's where the pain is coming from. He tells me that we won't be able to get all the way to the bone, but we can do it right now if I want. And I do. So I get to play doctor and mark my own ankle where it hurts, and then he gets to actually be a doctor and use the needle. He used some numbing spray first and I didn't feel the injections at all. So he left me alone for a couple minutes to wait to see if the drugs worked. He comes back in the door all excited to find out if our experiment worked. I told him "New plan. The surgery is off, and you can just follow me around and inject me like this every couple of hours!" Turns out, that doesn't really fit in his schedule. Go figure. So I told him I could still feel a small pinpoint of pain, like he didn't get to the center of my ankle, but I think this worked. He asked what a normal amount of walking is for me. I told him this weekend I tried to take the dog for a walk and made it 4 houses before I had to turn around and come back. So he kicked me out of his office and told me to go take a walk and see how many houses I could get. And call him the next day to let him know if it worked. So I went for a walk. In the beautiful, sunny, 60 degree spring weather. And I saw flowers, and a park, and birds, and a spray painted fence sign. Beautiful. And when I got home, I checked my route. I knew I had gone more than 4 houses, but I'm a scientist, and I need hard data. I had walked 1.01 miles. And the only pain I had was that same tiny pinpoint that we didn't reach. It felt amazing. Then I went to the grocery store and shopped, which is normally a vicodin-inducing activity all on its own! The other thing Dr. McGorgeous told me is that I would pay for this, pain-wise, tomorrow. And I can tell you that as the injection is starting to wear off, I will be paying for it. Whatever! I went for a walk, who cares?! Also, we decided that I will definitely have my shin opened up. Because I don't have enough scars. Actually, that's not the real reason. I lied. It's really because my anterior compartment is all messed up, and we're (do you like how I say "we" like I'm actually going to help with the surgery?) going to dissect the tendon sheath. So like I said, we just think I need more scars.

"Anyone can give up, it is the easiest thing to do. But to hold it together when everyone else
would understand if you fell apart, that is true strength"
-Unknown


I'm trying.

Up to date

So this is the last post I need to catch you guys up to where I am now. I'm excited to share these last few details, but even more excited to have the story told, and be able to post about my current struggles in real time. So back to the girl with my injury. We shall refer to her as Ankletwin. Because from the first minute we met, it was unbelievable how similar we were. To the point where we refer to "our" surgeries and "we" went to the doctor. It wasn't until I met her that I realized how lonely the chronic pain had made me. I mean, I still live a pretty awesome life, but I've also definitely changed. When I think back to my old workouts.....60 min on the elliptical doing 6 min miles on level 8. Weights 3-4 times a week. I had just finished a 10 week beginners yoga course when I was injured. That's not my life anymore. I haven't worked out since Jan 13th, 2009. I'm now the person who has to calculate the distance between two stores in the mall so I know if it's feasible. My old life ended that day. And I'm still working on accepting that. But I have always been a fighter. And I refuse to stop fighting to get a life I can enjoy. After talking to Ankletwin and realizing that other people struggle in situations like this every day, I decided to take my feelings from private to a blog. I truly do hope there is someone who reads this and finds some comfort in the fact that I'm fighting too. And I have a collection of characters, from my massage therapist, to my physical therapists, nurses, doctors, friends and family who refuse to let me quit. I saw my surgeon on March 8th for the one month follow up to my 3rd PRP injection. My pain is worse now that it's been in at least 6 months. The surgeon can see that the swelling is worse now than it has been in months. I'm very clearly backsliding. I knew it before he even walked in the exam room that day. And for the last few months my biggest fear has been that he will give up on me and send me to Pain Management. I'm 26, and the prospect of spending the next 50 years using narcotics to manage my pain brings me to tears. But there's always that ray of hope. I tell the surgeon that while the pain is worse, it's also changed. I used to just feel pain everywhere from mid-calf down. And after the 3rd PRP, all the "background noise" pain disappeared, and I can now point to EXACTLY where the pain originates from. I can pinpoint it. And once this pain starts, if I don't stop whatever I'm doing (ex: grocery shopping) the pain completely debilitates me. And here's what he comes back with. When he repaired my ligament, he used a suture to reattach the ligament to my bone. The area of pain I'm pointing to, and the swelling I'm having are directly over this suture. He thinks my body is rejecting the suture as a foreign object, and literally trying to push it out through my skin. So, two weeks from today, he is reopening my big incision to remove that suture. He's also opening my smaller incisions to remove scar tissue and inflammation. And while there is nothing "hilarious" in this post, this is the current state of affairs. I'm allowing myself a small ray of hope, but also mentally preparing myself to go back on crutches, back in a cast, and back to my un-showered, dignity-lacking, post-surgery self. So no worries....hilarity will ensue.

Rollercoaster

So after sleeping through Christmas and New Years, another sacrifice I had made in this whole ordeal, I expected to pretty much feel amazing. After all, I had already been through a PRP treatment, so I totally knew what to expect, right? (wrong.) At one point just after New Years I almost emailed Dr. McGorgeous to ask him if I was ok. I didn't feel anything like I felt the first time. I felt awful. I was still on painkillers after 10 days! After getting back from my parents, I made an appointment with my massage therapist, DJ MT. I always feel like I'm at my wits end until he drops some piece of knowledge about my anatomy that I don't even know. So during this massage, we keep pinpointing this certain part of my ankle. Apparently, my anterior tibialis is very angry with me. I wikipedia'd the crap out of anterior tibialis, and found "It functions to stabilize the ankle as the foot hits the ground during the contact phase of walking."
Hmmmm, anterior tibialis seems important. BUT, since we are finding the hilarity in chronic pain, I am willing to both copy AND paste my favorite line:
"The anterior tibialis aides in the activities of walking, running, hiking, kicking a ball, or any activity that requires moving the leg or keeping the leg vertical"
Way to sum it up, Wikipedia. Seriously.
At this point, I'm just a few days away from my follow-up appointment with Dr. McGorgeous. I've also just passed the one year anniversary of my injury. I wish I could have invited all of you to the pity party I threw myself that day. It was a riot. Because by this point, I know that my second PRP isn't working. The pain is back. So what does Dr. McGorgeous have to say when I see him next? He says that we are going to do another PRP and we are going to focus on my anterior tibialis. And I am about to be the first patient he's ever done 3 PRP treatments on. Ummmm, do I get an award for that? But towards the end of the appointment, I kinda......lost it. Like, I have always tried to be really cool around the surgeon, because I have the emotional maturity of a middle school girl. But the end of this appointment was different. I told him I was scared that the time we spent marking my ankle pre-op went too quickly and that maybe because we were marking so quickly, we weren't finding the exact right spot. He asked me to go see DJ MT the day before my surgery, and have him mark me!!! Talk about teamwork! So that's what we do. And on Feb 4th, I show up for my 3rd PRP treatment and my 4th overall surgery. As I was sitting on the hospital bed waiting, I saw one of my old nurses walk past. She disappeared out of view and then reappeared. "Mary! You're growing your hair out!!!" For future reference, here are three ways to know that you spend too much time in the hospital. 1. They recognize your face. 2. They remember your name without a chart. 3. THEY HAVE SEEN YOU SO MANY TIMES THEY CAN TELL YOU ARE GROWING YOUR HAIR LONGER. Geez. Here's another funny for ya. Dr. Grinch recognized me and still tried to deny me the anti-nausea drugs. And I still got them. +1 for me! So we do it allllllll over again. And I take another week and a half off of work. About a week after the surgery a co-worker invited me to her house for a party. I had been trapped inside due to my surgery and the nasty Midwest winter weather for awhile, and I was excited to go. But more than anything I was excited to meet one of the other guests. According to my coworker, this girl was about my age, had the same injury, and the same doctor. This was going to be interesting.

What's that feeling? Oh, it's hope...

So what does a PRP injection feel like? Well, other than sleeping 20 hours a day, it was more fear of pain than actual pain. Don't get me wrong, I'd definitely choose a spa day over a PRP injection, but on a scale of 1-feeling.your.ligament.snap.and.ankle.bone.break, it's registering down around a 4 or a 5. Four days after the surgery, the swelling was down and I had DEFINITELY noticed a change in the amount of pain I was feeling during the day. A change for the better!!!! The real test would be going back to work. Tuesday was my first day back. Things were OK, and for that whole day I let myself wish and dream and hope that this was the end of my journey. I mean, Tiger Woods had this therapy, and it helped him! It didn't help with the whole cocktail waitress situation, but whaddya gonna do? Wednesday comes and goes, then Thursday, and by Friday I was back to square one. The swelling hadn't come back, but there was that pain. My old familiar friend. The pain that is so much a part of my life that I truly can't remember what my body used to feel like before the pain moved in and forced me to carry it around. And so I wait. And I plot. I don't see the surgeon until mid-December. In the meantime, I decide that going back to work too soon was the reason the procedure didn't stick. So I continue to plot. And my appointment with Dr. McGorgeous finally rolls around. He takes a peek at the ankle and tells me it's a good sign that the swelling went down because it means that my body does respond to this therapy. When you're dealing with an experimental procedure, any sign that it works is a good one. So I explain the pain and ask him how close to Christmas he's performing surgeries. This guy knows me pretty well at this point and he gives me a "Cut the bullshit" look and asks when I want my surgery. I tell him December 22nd. He tells me he needs to leave the hospital to catch his plane by 11:30am, and asks if I can be there at 7am. Seriously, I would let the guy operate on me in his kitchen if it meant this thing would get fixed. So I agree to show up 3 days before Christmas so that I can have 11 straight days of recovering without having to stand on it at work. It also means another round of pre-op phone calls, another physical, more paperwork and all the other boring stress that goes along with an operation. And sure enough, I show up on December 22nd for my next procedure. Same room, same nurse, same smells and sights and sounds. Same x marks the spot on my ankle, same signature on the paperwork. Same initials from the surgeon reminding him this is the correct leg to operate on. Same pinch and burn of the IV. The familiarity and routine of undergoing surgery definitely registers somewhere in my mind. Until Dr. Grinch shows up again. Of course. And tries to deny me my anti-nausea drugs. I tell him what happened last time and tell him to check his records and order my drugs. He doesn't argue. Have I ever mentioned how much I absolutely love getting my way? Well, I do. And keeping with the routine, I wake up in the same recovery room. I get sent home to sleep. I manage to wake myself up the next morning and forgo the drugs long enough to drive the 2 hours to my parents house. Once there, I take my drugs and proceed to fall asleep for 7 days. Seriously, Christmas day I was only awake for 2 hours. But these are the sacrifices I'm willing to make if that's what it takes to heal my ankle. And this has to work. It has to.....

I'm A Puker

Ahhh, the Pre-Op room. This room, along with the doctors, nurses, scheduling department, billing department, physical therapists, massage therapists, and pharmacists are all quickly becoming first-name-basis friends. So I'm in my bed, wearing my gown (this is all so familiar) and trying to keep my dad amused while we wait for this show to get on the road. So in walks my anesthesiologist. Although this procedure doesn't require a fully intubated-type of anesthesia, I will still be out for it. I tell him that every single drug I've ever been given, from Tylenol 3 to straight up morphine, makes me vomit. A lot. As in, in my purse I have packed bags for me to throw up in on my way home. And I ask him for some anti-nausea drugs in my IV while I'm having the procedure to prevent it. So the doctor....we'll call him Dr. Grinch, explains to me that drugs have side effects. Um, really? And that I should avoid taking them if I don't need them, and in his 394803404 years of practicing medicine, he has never seen anyone get sick off the type of anesthesia I am about to get. So my dad jumps in and tries to explain that if anyone would get sick off of it, it's me. He starts to disagree with my dad (you would think he's gotta pay for anti-nausea drugs out of his own paycheck or something) when I interrupt. "Ok, so WHEN I wake up vomiting, can I just have the drugs then???" And Dr. Grinch gave me his best evil stare and told me yes. So it's just about time to go. Dr. McGorgeous comes in to make the marks on my ankle, where my blood products will be injected. I'm surprisingly not nervous about this. If I got through last May's surgery, I have no doubt I can handle it. So we head back to the very same operating room, and the next thing I know, I'm awake in the recovery room. Being an old pro at the surgery thing, I did not throw a temper tantrum over having to eat crackers, and I received some very lovely drugs. With my dad sitting next to me, I reached for the cup of water to wash down the drugs when it hit me. The nausea. Like none I had ever experienced. I literally threw my head back into the bed to force the room to stop spinning, and we got the nurse to push the anti-nausea drugs Dr. Grinch swore I wouldn't need. 2 doses and an extra hour in the recovery room and I was wheeled to the car. Back in my black boot, I was nervous about the pain and walking. The only thing I have to compare the situation to is what happened before. So I go home and sleep for all of Thursday, Friday, Saturday, and half of Sunday. I'm not kidding, 20 hours a day, I was OUT. I wasn't in nearly as much pain as the first surgery, but it seemed like my body needed the recovery time, so I called in sick to work on Monday and slept some more. By Tuesday, I was out of my boot and back at work full time. I wasn't set to see the doctor for 4 weeks. He said the therapy can take that long to start working. I had noticed by the day I went home from work that the swelling I had in my ankle had changed. It wasn't as widespread as it had been before, with the main swelling over my big incision. A good sign??? I had to wait 4 weeks to find out!

The Results Are In!

Now that you've met my full cast of characters, lets get back to the results of the second MRI. I spent the whole night trying to figure out what I wanted them to be. Because, you know, I can control things like that. I certainly don't want the results to show some massive problem that sends me back to the operating room. That would be devastating. But if the results come in and show there is nothing wrong, and this is just the amount of pain I'm expected to live in for the rest of my life, I'm going to drive out to the country, dig a hole, and live in that. So I'm sitting in Dr. McGorgeous's office again, looking for red flags. How long have I been waiting? Not too long..... How many doctors are here to tell me the news? Just one..... He's here and he has things to show me. He pulls up my MRI on the computer and shows me the osteochondral fracture. It's still visible, it's healing slowly, but that's what bone does. See this empty circle in your fibula? That's the bone screw that hasn't finished dissolving yet, give it another 18 months. The ligament looks GOOD, blah blah blah. I'm tuning him out. Until he gets to THE PROBLEM. Duh duh duh....I have.........................................................INFLAMMATION AND SCAR TISSUE in the ligament and all the surrounding tendons! Um, I know. I have inflammation and scar tissue BECAUSE I'VE BEEN WALKING AROUND ON A SCREWED UP ANKLE FOR 10 MONTHS! THAT'S YOUR CONCLUSION???? THAT'S NOT A DIAGNOSIS! THOSE ARE MY SYMPTOMS! COULD YOU BE MORE VAGUE?! Anyways, I'm obviously not saying any of this to him, because he's adorable and it would be awful if he thought I was crazy. So I just ask him what we are going to do about it. And he tells me about a new procedure that's still experimental, but has shown some promising early results. Now, I have a degree in Molecular and Cellular Biology. I DO research. This intrigues me. So he explains Platelet Rich Plasma Therapy, or PRP for short. My surgeon, unbeknownst to me, is one of the pioneers in his field, and has won numerous awards and honors. I knew I liked him for his mind, and not just his looks ;) Here's the Cliff's Notes version: When you cut yourself, you form a scab. The cells in the scab (the platelets) tell your body "HEY! LOOK OVER HERE! WE HAVE A PROBLEM! FIX IT!". And your body kicks into action and repairs the injury. So we are going to draw my blood, take out the platelets (and the plasma, the juice your blood cells sit in) and inject them directly into my problem ligament and all the tendons showing inflammation. This should trigger my body to go fix it. I will be under anesthesia, no knives or cutting, just a couple needles. It's a short procedure, and I should only be out of work for a couple days. He says that I may only need one treatment, or I may need two treatments. Regardless, we are going to get pre-approval from the insurance for 3 treatments, just to be on the safe side, although he's never done 3 treatments on anyone. I'm beyond excited! In just two shorts weeks, I go through ANOTHER pre-op physical (they're only good for 30 days) and find myself back in the pre-op room waiting to see if this experimental treatment is the key to my recovery!

Keep You Guessing

Before I get to the results of the MRI, I have one more person to introduce you to. My massage therapist. And don't even roll your eyes. I know what you're picturing. Hot stones, creepy relaxing music, dim light. OMG, sounds amazing. That's not what we're talking about here. Way back in the beginning of time when I first found out about my surgery with Dr. McGorgeous, I was limping around the back of my house to throw the trash in the dumpster we shared with a few other houses. One of these houses had a few Big Ten football players living there, and one of the linemen saw my ankle brace and limp and asked what happened. We'll call him SanFran, since he now plays for the 49ers. So I tell SanFran what happened and as it turns out, he has THE SAME EXACT INJURY! And he also had surgery with Dr. McGorgeous! Small world, huh? He tells me not to worry, that I'm in good hands and if anyone can get me back to normal, it's our surgeon. He then tells me that the most important thing I can do for myself after surgery is find myself a massage therapist. Apparently, the football team does it for them, but I would need to hire my own. And if it's good enough for a now-pro football player, it's good enough for me. So in August, as physical therapy started to progress, I found myself a massage therapist who specialized in sports medicine. Well, I actually found two. The first one needed a book to figure out where the ligament I tore was, was afraid to touch my ankle, and then tried to take my top off. Please, you gotta buy me dinner if you want to take my top off. The second massage therapist I found was THE ONE. Our first meeting was wonderful. He wasn't afraid of my scars, he got right in there and started to feel things out and ask me questions about my injury, my surgery, and my pain. He moved up from my ankle into my calf and started loosening muscles and releasing trigger points. FYI, "trigger points" is Latin for "tiny spots of Satanic pain". Seriously. At one point, the massage therapist (lets refer to him as MT. No...that's boring. How bout DJ MT? Yup, that's a winner) tells me that my calf muscles are so locked down from having to protect my ankle for so long that he doesn't know how I can walk. And standing up from the table and trying out my ankle again, I wasn't sure how I had walked before either. I think my visit was $35 and I would have paid him $35,000 for what he did for me that day. So DJ MT became a regular stop on my weekly rounds of ankle-getting-better-ness. And while he hurts me nearly every time I go in there, I know that the pain is helping me get better, and that he only likes hurting me a little bit. Kidding. Kinda. He did make me puke once. He taught me what "referral pain" is. Did you know that I have places near my knee that you can push on to make my ankle hurt? It meant that some of my ankle pain wasn't actually ankle pain, and he could fix that. Anyways, DJ MT plays a crucial role in upcoming chapters, so I wanted to introduce him now. But back to McGorgeous's office, where I'm waiting for the results of my second MRI. Stay tuned....

PS- that's what my ankle looked like 4 weeks after surgery. I figure we're good enough friends now to share.

Faking It

As September progresses, I was also progressing. Range of motion, strength and balance were all making a return to my life. Anyone who asked how I was doing got a sunny, cheerful response. I bought myself new shoes to celebrate moving out of the brace (omg, I felt naked without it!). I should have won an academy award for the amount of acting I was doing. The only people who knew I was still in a LOT of pain were my physical therapists and my surgeon, who prescribed a topical anti-inflammatory to help with the pain. I guess as far as everyone else was concerned, I just didn't want to talk about being in pain anymore. I was at the 9-10 month point, and starting to notice the changes in myself from the chronic pain. I wouldn't call it full fledged depression, but I did notice that while I might PRETEND to be interested in a friend's story, in my head, I couldn't believe some of the things people were complaining about. The pain was starting to change my perspective on life. And whether that's a good thing or not remains to be seen. So back to the pain. Ever since the day my ligament was repaired, all I had heard was that the pain was "normal". Normal, normal, normal. But as October began to slip away, and the topical prescription was having no effect, I bumped up my next appointment with my surgeon. If there is one thing that I plan to take away from this experience, it's to trust my body, and trust my brain. My body was telling me that my ankle still hurt. And I don't mean like, oh, maybe I'll take a Tylenol. I mean, pain no different from BEFORE I went through that surgery. Nothing was different, and nothing was better. And my brain was telling me that something was still very, very wrong. Dr. McGorgeous came into the exam room where I was prepared for a battle. And he took the words right out of my mouth. He said when he saw my name show up on his patient list that day, he thought about canceling the appointment and just sending me straight for an MRI. And this is why I love Dr. McGorgeous so much. Because even when I doubt myself, he doesn't. He BELIEVES me when I say it hurts, and I've seen enough doctors to know that he honestly wants me to get better. So at the end of October, I ended up back in the MRI machine. Only this time I was at a different hospital. No soothing music, no warm blanket, no nice nurses. I was so cold, and shaking so hard, that the tech came over the speaker and told me to "quit moving, the pictures are coming out terrible". Awesome. This is after they ran 1.5 hours late, and told me to "go for a walk". Hilarious. And I spend another night wondering what those pictures were going to show, and waiting for Dr. McGorgeous to tell me my fate.

Out of the Boot!

So two months after surgery is right around the time things got really exciting. I transitioned from the boot to an ankle brace, which was an a-ma-zing upgrade in August in the midwest. I looked less gimpy, and I was giving it my best shot at walking less gimpy. Overall, I guess you could say that I was hopeful. August is my birthday month, and it just finally seemed like I had turned the corner from surgery. Physical therapy was.....going. Maybe not great, but it was going. I was receiving a fun treatment called "electrotherapy", where they hook electrodes up to your ankle and literally run a current through you. I've never stuck my finger in an electrical outlet, because I have common sense, but I'm thinking that's a lot like this. Also involved was icing. And I know what you guys are thinking. Icing.....mmmmmm, cupcakes. But seriously, we are talking physical therapy here. And I'm about to give you all an icing lesson, free of charge. Because I'm just that kind of person, and also because I can guarantee none of you know the theory of icing. So you're all doing it wrong. So lets get started class. Phase one of proper icing is fleeting and pleasant. Your skin feels cold (duh). Phase two is where all of you quit, guaranteed. Why?? BECAUSE IT FREAKING HURTS. I mean, full on rage, don't talk to me, I'm not going to survive this pain. That's why you all quit. And phase three, where my lovely physical therapists got me each time, is the point where your ankle actually goes numb. It takes a good 15-20 minutes to get there. So we combined the electrodes and the icing. And don't think I didn't question the sanity of the therapist the first time she wanted to combine electricity and water. But I never died, so I guess it's fine. Except, don't try it at home. Or try it, but don't bother suing me. I'm broke, I have a $100,000 "sprained ankle". So as August turns into September, we reassess my ankle for the insurance company. You know, so they can see if I've recovered enough to quit paying for PT. And I'm progressing on strength. And range of motion. Balance is the next thing they ask about, and then that one pesky detail about how much pain you're still in. So it's nice to see from week to week how much better I'm getting at moving it, and the strength that's coming back. Balance is a huuuuuuuuge challenge because it requires both range of motion and strength at the same time! And pain. Oh pain. There's no improvement. But I am being reassured at this point that pain is normal for the first 6 months. So, I keep calm and carry on. For now.

The music, it understands me...

"I always knew I had the answer
But I never understood the question
Indoor living
Lacerated to the bone

And now we've realigned the edges
I'm doing very well I thank you
All this empathy is starting to wear me down
I wish I was someone else"

-A Life Less Ordinary/Need a Little Help, Motion City Soundtrack

Back to Work

Literally and figuratively. The doctor said to take 6-8 weeks off of work, and seeing as how 1) I'd only been at my job 1.5 years, and 2) I had no idea what I was getting myself into, I chose to take 6 weeks off. So I went back to work the Monday after 4th of July weekend. The first day was nerve wracking. Would I even remember how to do my job? Did they mess everything up without me? Did they figure out that work is better without me there? It was exactly like your first day back at school after summer vacation. I tentatively explained things to my boss, who had kindly asked me in an email 3 days after surgery if "I was walking yet". To this day I don't think he thinks there is anything wrong with me. But anyway, it seemed like everyone was happy to have me back. And I was happy to be out of the house and "normal" again. Except that I was exhausted. Now, I was very careful not to turn nocturnal with all my time off, but there's really no comparing staying home all day to rest with being at work 8 hours a day. The week was EXHAUSTING, and I tried to sit as much as possible. It made me feel pretty crappy to be back in the laboratory, and still pawning off work on the people who had covered for me for a month and a half. They were all so good about it, but it just doesn't sit well with me to need that much help. That's kind of the story of my life in this blog. I resent needing so much help. I'm a horrible person! Whatever! :) So in the midst of all this back to work stuff, I am also starting physical therapy again. I got the same two girls as the first time, and we jumped (LOL, that's hilarious!) right back into it. My philosophy on physical therapy is that I had ONE opportunity to rehab my ankle, and if I slacked off, I would probably regret it the rest of my life. So I did everything they asked.....again. And I dealt with the pain as best I could. I was so excited at this point, because I had dealt with this situation for 6 whole months. Six months of chronic pain, doctors who didn't listen to me, surgeries that terrify professional football players, all while trying to live my life. And if you do everything right, and you play by the book, everything works out perfectly, right?