Cast and Crutches - Sat, 31 Dec 2016

On Monday Dec 19, it felt like I might have sprained my ankle. It was my first squash game of the day and I planted my foot and I felt a tiny pop in my ankle. It wasn’t too bad and I tried to continue but less than a minute later I felt another pop in the ankle. Now it felt like a badly sprained ankle.

I immediately told the guys that’s it for me today, got some ice and iced it for 40 minutes while my buddies finished up their matches. It didn’t feel too bad after the icing and fortunately I was carpooling with Rob and it was his turn driving and he took me home.

That night it didn’t swell up much, but it hurt like crazy. The next morning, my wife took me into our nearby Sports Medicine clinic. They took X-rays and could see on the X-ray (I’ll try to get it and post it here), that I had an avulsion fracture of the ankle. That means the place the peroneal tendons (which go from the outside of foot back to the calf) are attached to the ankle broke off taking a tiny piece of the bone with it. The X-ray can’t see the tendons, but it did show the bit of bone.  

The peroneal tendons (which I never knew existed two weeks ago) are like two rubber bands glued to the bottom of the fibula. Both the rubber bands and the “glue” are stronger than the bone and with pressure, something had to give. Now the two tendons were held in place at the top and bottom but not in the middle and were floating. The doctor put me in a solid cast which could bear weight, and made an appointment with the foot surgeon to see if I would need an operation.

So a week of hobbling around in that cast and crutches, with my wife and daughters driving and otherwise helping me. On Wednesday Dec 28, I met with the foot surgeon. She told me this is unlikely to heal well on its own. I had peroneal tendon subluxation which means the tendons were out of place.

Yesterday, Dec 30, I went in for day surgery. I had my wisdom teeth removed 40 years ago, but this is my first surgery in a hospital. I got changed and they set me up on an IV in the waiting room. I would be getting a spinal, which would freeze my lower half and I’d be awake. They asked me if I wanted to have a sedative applied so that I wouldn’t remember the surgery. i turned it down because I wanted to experience it.

When surgery time came, they rolled me into the operating room. There were two doctors and about 4 others there, including the anaesthesiologist who would then administer the spinal. Barely felt that. The IV previously was worse. The operation was to take about 45 minutes. I couldn’t see anything because they had a big canopy over me. I couldn’t make out much of what the doctors were saying because they were talking very quietly. I only had the anaesthesiologist who came around to check on me every few minutes. The spinal was great. I felt nothing! When they came to cut a small groove in my fibula so that they could place the tendons, I got to enjoy a few minutes of listening to what sounded like a circular saw, but again I felt absolutely nothing and couldn’t tell anything was being done to me. My anaesthesiologist asked me if the saw sound bothered me, but I said no, it was just like being at the dentist.

The operation took about 1 hour and 15 minutes, which was 30 minutes longer than expected because when they got in, they found the tendons were quite frayed and needed repair, which they did. It actually was a good thing I did the surgery because the state of the tendons would have caused me problems in the not too distant future if I had chosen not to have the surgery.

After surgery, I was taken to the recovery room for an hour and I was watched closely. My surgeon came in and said everything went well and told me about the frayed tendons that they repaired. They also put me in a new non-weight bearing cast which I would have to be in for 6 weeks and then a walking boot for 4 weeks. I had appointments set up for 2 weeks and 6 weeks from now with the surgeon to check progress, but she said I can come in 5 weeks instead of 6, and we’d see if I could switch to the walking boot to make RootsTech easier for me. Either way, crutches or boot, I wasn’t going to miss RootsTech. Hopefully it will be the boot. Crutches would make quite a scene as I go up onstage to present Double Match Triangulator in the Innovator Showdown semi-finals.

After the recovery room, my wife joined me back to the staging area to ensure that the spinal wears off which takes a few hours. After I could get up on my own steam, I was released and my wife drove me home.

It took until 10 p.m. or so until the full spinal wore off. Then the pain started and it was bad. I took two Tylenol 3’s which the doctor gave me but that hardly seemed to do anything. I barely slept last night. In the morning, my wife who is a pharmacist, recommended two Ibuprofens. Within an hour, that did the trick and most of today has been pain free. I must have had swelling from the operating I couldn’t see under the cast and those helped relieve this.

So, what a way to start a new year. At least I will be on my road to recovery now and I’ll do what I need to do to make it to RootsTech. This is likely the end of my 30 years of playing squash. My last major injury from squash was a completely torn achilles 5 years ago on the same leg, which was fully healed and unrelated to this new injury. I’ve had other aches and pains and nagging injuries from squash, but these two, with the out-of-action time that they cause to the rest of my life, are just not worth it anymore to me. This one just came too close to ruining RootsTech for me. So lots of walking, biking and swimming should do well to keep up my fitness levels. I will miss my squash guys and their camaraderie over the years though.

A side benefit of the next six weeks: I’ll have lots of time at my computer to work on Behold and do genealogy stuff.

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Update:  Monday, Jan 16, 2017

Last Friday, two weeks after the operation. They took the cast off and removed the stitches. They put a rectangular bandaid over it and a sock over that, and no longer did I have to wear a cast, but I’m in a walking boot – actually the same one that I got for my achilles tear 5 years ago, so for up to 8 more weeks, I’m a stormtrooper again. Four weeks non-weight bearing with the boot with crutches, and 4 weeks after that still in the walking boot weight bearing without crutches. I’ll wear the walking boot during the day and at night.

Up to today, I was taking a shower sitting on the edge of the tub with my right foot out of the tub with the cast and then the boot in a bag so it wouldn’t get wet. On Friday the doctor told me that starting today, I could take off the boot a few times a day to shower and to do exercises to bend my foot up and back (but not side to side). So today I took off the bandage and washed my right foot and leg for the first time in 2 1/2 weeks. It felt so good to do that.

The incision was a slight curve about 3 inches long. You can see where the stitches were removed but it’s all healing nicely. It’s a bit tender but doesn’t hurt and there’s very little swelling. My right calf muscle is going to pot though. I’m sure I’ll bring that back up to snuff not too long after the boot comes off and biking season starts.

My next appointment is in 2 1/2 weeks which will be 5 weeks from the operation. That was supposed to be at 6 weeks when I can start weight-bearing, but my doctor moved it up because I was going to be out of town at RootsTech the next week. She’ll evaluate then and tell me if I’ll be taking crutches to Salt Lake CIty.

Funny that my right leg feels fine. It’s the upper quad in my left leg that I partially tore 3 months earlier that’s giving me more problems, especially at night. But all the extra work my left leg is doing now to support all of me is helping it.

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Update:  Thursday, Feb 2, 2017

Had my post-op five week appointment today. It’s looking really good. There’s no pain whatsoever. Foot can move any direction nicely.

So the word for now is that I can wean off the crutches and start weight bearing on the boot. By Monday, I should be good to go without crutches and can make my trip to Salt Lake City in the boot and not have the hassle of taking the crutches. That means I’ll be able to pull my carry-on behind me rather than have to wear a backpack. This will make the trip much easier than it would have been if I couldn’t weight-bear.

The added bonus: I only have to wear the boot while walking. I can take it off if I’ll be in one place for a while, and I also won’t have to wear it to bed any more.

In two weeks, I’ll start physiotherapy to get the foot and leg muscles back in shape and will also get some home exercises to do. In five weeks, I can stop using the boot completely (and likely will be able to start driving again), and in seven weeks, I’ll have one more visit with my surgeon for what will hopefully be a final inspection.

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Update:  Friday, Mar 10, 2017

Now 10 weeks after surgery, I had my physio appointment. All on schedule. End of boot. Foot feels pretty good. Going to start driving again.

Due to not wearing the boot all the time and the exercises, my calf has started to build back a bit of muscle. It will still take a summer of bike riding, swimming and walking to build it up again, but now, after 12 weeks, everything can finally get back to normal again.