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.