A little Milestone!

I'm writing about something special that happened  because I don't want to forget.  Yesterday, October 5, 2011, I went to the Wyndham Hotel with my Team at work for a business meeting.  I climbed stairs from the lobby to the second floor - on my own two feet - without holding on to the handrail.  (Of course, I watched every step I took, but it was at a normal pace!)  Just one more little milestone in my ankle replacement journey.

I work fulltime now from 8 to 5, and trust me - by 12:00 - 1:00 PM, my foot and ankle are noticeable swollen.  But it's not so much painful as it is tight, with limited movement than actual pain.  My walking pain-free seems to be improving as time goes on.  There are a few times that I walk and don't have any reminders about my ankle.  I never thought that day would ever come.  Also, I don't have a limp when I walk now and I can actually get a little speed in my steps if I'm in a hurry. I'm actually wearing regular shoes (best comfortable flats are Naturalizer).  I'm getting where I want to be.  I'm sure Dr. Royer will be glad also when I see him next month.  More later!

XOXO

Back to "Normal Life"

I'm in Month 4 after my total ankle replacement and I am back to work full time every day.  I saw Dr. Royer  3 weeks ago, and he gave the OK to increase work from 4 hours a day to full time.  I was quite hesitant (ankle-wise) to have more increased time on my foot along with increased walking, but it seems to be doing pretty good for the most part.

I do have good days and bad days.  I prop my foot all the time, but there are those days that it swells and when it swells, it hurts.  There's no other way to say it.  It's then that I get the 3 or 4 pillows back out, stack them high, prop my foot and ice it down.  The swelling goes down in a couple of hours.

I can pretty much wear regular shoes now and that makes me happy.  I can walk without a limp and that also makes me happy.

I will see Dr. Royer before Christmas, and then my visits will.be every 6 months and eventually every year.

My ankle and across the top of my foot is stiff, but I'm told that is nothing that should concern me. I can take stiffness as long as there is no pain.  There are those few times that I walk and I actually forget there's anything different with that ankle.

When I finished PT 3 weeks ago, I had a scheduled office visit with Dr. Royer.  He could tell that my ankle was very swollen and I told him that it really hurt. even though I had lots of movement!  I could put one finger on that area and show him where the pain was/  He said that it was soft tissue impingement and decided to try a cortisone shot in my ankle joint in the top right of my foot. That shot helped alot with the swelling and even helped with the pain. Of course, it took a few days to really notice any difference.

There is no doubt in my mind that God led me to Dr. Royer. I love Dr. Royer.  He has taken such good care of me and is really interested in this new technology.  I am, indeed, his test subject.  I have done more, faster, without his permission, than any other patient.  That's because I am very determined to go, do and see everything I've been missing for the last two years.  The man has given me my life back.  Thank you, God and Thank you, Dr. Royer!

Here are the latest pics of my ankle.  It looks almost  like the other foot.  I hope these help someone.........somewhere. 

More updates later!

XOXO  Jan

Pretty Close I'd Say

Overdoing it takes a toll!

Swelling in ankle area and lower leg after being on it 2 to 4 hours:

After Ice and Elevating it for 4 hours:



Week Twelve and Thirteen - Doing more and more!

One of the most frequently asked questions is, "Are you still having pain?"  Answer: Yes - in varying degrees.

Since my last post, I have been through Physical Therapy which helped tremendously.  I did foot exercises with the bands, balanced on one foot, did circles on the floor with a circular disc and apparently I've gone just about as far as PT can take me.  I have two more visits this month and I'm pretty sure I will graduate from PT if I'm still progressing.  I'm walking without a limp now, and the rest of the healing, decrease in swelling and pain will just take time.

In the morning, my foot and ankle are very stiff.  It takes awhile to loosen it up.  By the time I get to work at 9:00, it's getting more flexible.  I prop my foot up underneath my desk the entire time I'm at work (unless I'm walking, or in a meeting) and by noon or 1:00 it is starting to swell and hurt.  By swelling, I mean it is two or three times the size it was when I woke up.  That is painful.  With my reduced hours, I leave work at 1:00 and go home.

Once home, I elevate it high on 3 or 4 pillows and ice it on and off all afternoon.  It helps the swelling and pain.  I go back to Dr. Royer on September 2nd and he will re-evaluate me for how the STAR device is holding up and decide if he thinks I can tolerate full time hours at work.  Hopefully, in September I can be back full time.  My bank account certainly needs it and my Team at work needs me.

I went to a couple of stores with my daughter and granddaughters yesterday and held up okay, though there was pain, I tolerated it and didn't need a pain pill, but couldn't wait to ice and elevate it for several hours afterwards.  So that's where I am right now.  I'm definitely more active, I don't use a cane any longer, I'm doing more and going more places, but there's a price to pay for that increased activity.  Hopefully - in time, this will get better.

The upside is that I'm doing more and staying up on my foot longer.  The downside is that it swells and hurts.  The good thing is ICE and ELEVATING it.  Feels so good!!!   Like an ice cold beer on a really hot day.  :)

Would I do it all again if given the choice?  Definitely.

Thank you Dr. Royer!!!  You have given me my life back.

Week Ten and Eleven - Back to Work

Swelling from Standing 

Two weeks ago at week ten, I went back to work.  Dr. Royer has cleared me to work 4 hours each day (in the morning) because my foot swells after I've been on it after 4 hours and it is painful.  I can't complain too much, though, because I'm a lot more active than I've been in months!  I no longer have the foot and leg brace that I wore for almost one year prior to my total ankle replacement which is nice, because the brace made my walking very stiff and it made my foot and leg hot.  In this 100 degree-plus weather in Texas now, I'm so glad that's gone.


I have Physical Therapy twice each week and I started out by doing range of motion exercises but now I am doing resistance band stretching.  Doing those exercises doesn't hurt.  Walking does.  Right now each day is different in measuring pain.  One day - PAIN, the next day - NOT.  One thing is for sure:  the longer I'm standing or walking, my foot WILL swell and then there is pain.  Major pain.  


After work and/or Physical Therapy, I immediately go home and put my foot up on 4 large pillows and put an ice pack on and off for hours.  It is my only relief at the present time.  I take pain pills usually 2 or 3 times a week if I've stood on my foot over 4 hours.  I'm still using a cane but at this point, Dr. Royer or Physical Therapy will advise me when it's safe for me to ditch the cane.


I am finding out each day that recovery from a total ankle replacement is a long process!  This is something that is slow but sure.  Let me emphasize: S-L-O-W.  On the other hand, I am walking to and from my car to the entrance door at work, I can get out and put gas in my car.  I go to the grocery store, push the cart down the aisle and don't have too much difficulty as long as there is minimal swelling in my foot.  If it's swollen, I'elevate and ice.  I can see this routine in my life for several more weeks. (Hopefully no longer.)


More later!  I attached the photos which show the swelling in the ankle area.  This is week eleven.  Next week, it will be 3 months since surgery!  I'm so glad I had it done.  No regrets!

Swollen leg and ankle after 5 hours of being up today

Update!!!

Nine Weeks

Range of Motion Comparison

at Baylor Institute of Rehabilitation

June 21, 2011

Dorsiflexion                 3 degrees

Plantarflexion             19

Eversion                      20

Inversion                       8

July 12, 2011

Dorsiflexion              10 degrees

Plantarflexion           25

Eversion                    25

Inversion                   22

Week Nine - Released to Work!

Today I visited Dr. Royer and he had a big smile on his face when he saw me walking into the exam room.  That was because I was walking with my cane and Valerie, his Physican's Assistant,  noted that I wasn't even limping.  Big improvement!  I give all credit to God, Dr. Royer and my wonderful team of Physical Therapists @ Baylor.  Plus, I've been pushing my recovery all the way since Day One which is why (when looking back on it) I was in the pain at first.  Those 3 weeks of laying in bed still linger in my mind and although I know it was necessary for the new STAR ankle, it made me want to start walking as soon as I could, and as much as I could. 


He has released me to work in the mornings for 4 hours until September when another x-ray is taken and he re-evaluates me.  The x-ray is all knowing.  If there are any cracks or gaps, it will show up.  Dr. Royer studies it closely and so far it is perfect.  I told Dr. Royer today that he has changed my life! I hope he knows just how much.  It's a miracle.


Physical Therapy is still ongoing with range of motion exercises (no resistance yet).  That will come in time as will many other things they have in mind.  My PT assures me that I will be dancing again! Slowly, I'm beginning to see that in the horizon.  

Doing Range of Motion 

One thing that's consistent - the swelling comes pretty quickly when I'm up and walking.  Or sitting.  For nine weeks, I have had that foot elevated and iced for much of the day and that keeps it calm.  Walking and moving is very exhausting on the ankle joint at this early stage of recovery but it's going to learn to accommodate the movement.  All in good time.

I think to come as far as I have in just nine weeks is amazing.  There are times when I look back on the first photos of my foot and then I realize just how far I've come.  I'm moving my foot up and down, turning it side to side and doing circles.  I couldn't do that before my surgery!

More next week when I report how returning to work and getting into somewhat of a normal routine goes.  It's time to move on to a new phase of recovery.

Week Eight - The Ins and Outs, Ups and Downs

Physical Therapy all this week!

What a week it's been.  The photo above shows the lobby of the Tom Landry Center at Baylor Rehabilitation Center. This is where the pools are located.  Physical Therapy is upstairs.  Two steps forward and one step back.  That's been the theme of this entire week. My nature is to excel but I tried to do too much of my PT exercises at home and now am paying the piper.  I am getting more flexibility for sure, but the pain is still in the inside area of my ankle, plus increased swelling.  That one area is the first to hurt when I am on my foot too long and/or if it swells.  When it happens (daily, this week) I elevate it high and ice 20 minutes on and 20 off for hours at a time.  Let me put it this way --- our local Sonic knows my daughter and I from the many trips there for bags of ice! 

I am learning how to walk with a cane instead of a walker.  I have no balance.  I am having to re-learn how to walk again "properly".  One of my therapists has to remind me to put my heel down first when I step.  I've walked flat footed for so long that I've forgotten how to perform the rolling motion that is normal in order to walk.  The best part of Physical Therapy is the massage and ice at the end of the exercises.  HEAVEN!

Pool Therapy

In the pool, I am walking forward and backward and side to side.  I am slowly lifting my foot up and down and trying to step on my tiptoes.  I try to stand on one foot and balance.  (I don't have any balance.)  Well, maybe a little on my good foot.  The water is so much better on my joints because there is less impact and weight on them, plus it helps the swelling.

I will be released to return to work with reduced hours very soon.....possibly in one week.  I will work in the mornings because I am in significant pain and swelling after 3-4 hours without elevating and ice-ing my foot in bed.  It may take some time in returning to full time hours.

I am thankful for the progress that I'm making and grateful to Dr. Royer and my Physical Therapists (both of them) in helping me to get my life back to normal.  I feel so blessed to have these caregivers in my life.  I have made so many new friends throughout this journey so far.

Next week - more Physical Therapy and the countdown begins for return to work.

Peaceful Surroundings outside Tom Landry Center



Visit the Tom Landry Center at Baylor Institute for Rehabilitation and you will see patients with a wide range of physical pain and disability.  There are people with fractures that are healing, people recovering from strokes and heart attacks that are partially paralyzed, people with brain injuries learning how to use their hands to eat, their mouths to talk and eventually try to walk.  There are people using wheelchairs, walkers and canes to assist them.  Then there are people walking on their own power to go into this place hoping for healing.  It is very humbling to see so many folks in worse shape than I am.  You can feel God's presence at Landry - inside and out. Everyone is nice, from the valets to the older man who sits inside beside the main elevators.  I think he is a greeter or someone who can assist if you need information.  It is quiet.  The outside is very beautiful and peaceful.  You can sense that miracles happen here.

Week Seven: Where there's a Will, there's a Way!

Hello Physical Therapy

The last post ended with me stewing about not being able to wear the boot.  Well, it turns out I didn't have to!  Dr. Royer called twice the next day to check on me (yes, it was actually him that called), and we discussed the problem and the options. He said that he would go ahead and put me in a sturdy tennis shoe and start Physical Therapy and have them massage and do ultrasound on the problem area in my foot for pain relief.  Funny thing was...after I got into the shoe, I didn't have the pain anymore!  Is that not weird?  There is no explanation as to why that happened, but there was a huge difference from the boot to the shoe.

New Balance 927 Walking Shoe

I am going to the Tom Landry Center @ Baylor Hospital in Dallas for my Physical Therapy three times a week.  After this week's therapy, my foot is beginning to somewhat loosen up where it was "stiff as a brick" before.  It gets sore afterward, but a good sore. I don't push it - I go home and elevate and ice on and off for the rest of the afternoon.  The muscles, ligaments and tendons are manipulated like they haven't moved in two years.  Plus, I have a bonus!  I have two PT's working on me.  Hallie is going to school at UT Southwestern and she is my PT's assistant while she gets her degree.

They are twisting, turning and pointing my foot down and then up as far as I can go, turning from side to side as far as it can go, and pushing against a little resistance.  There is a round turntable on the floor that I put my foot on and make circles. (It's harder than it looks.)  After I finish with about 6 different kinds of exercises, the good part comes - the massage  - and it does feel delightful on a sore, achy foot.  I can point my toes now and they have me walking, and training my foot to walk like it's supposed to.  I have hardly any flexion in the bottom but a lot of that is due to the swelling and lack of use for so long.  When I left today, I said a prayer of thanks that Dr. Royer made the decision to go ahead with Physical Therapy now.

It's strange in a way how I'm running into people who are having major ankle problems.  When I was in the waiting room at Dallas Orthopedics, a man came around to people with rollabouts and walkers asking, "Have you had an ankle replacement"?  The lady next to me said, "She has!" and pointed to me.  He sat down and wanted to know everything!  He has been hesitant because he has heard of ankle replacements with the center incision on the lower leg and foot, the recuperation time of being in bed for 2-3 weeks and the pain afterwards.  I assured him that for me, there was no question that I was going to have this done.  I had hit a wall with the pain and limitation, so I was eager and ready to go.  He seemed really glad that we talked and said I made him feel a lot better.

There have been some emails from people who are getting almost disabled and are asking questions as well as this blog getting out there with information.  I wish I had stumbled across a blog before I had my surgery, but you know what?  It's an adventure and I expect the very best

Then and Now

You can see the massive amount of hardware in the photo on the left after my original fracture. In the photo on the right, is my brand new STAR replacement - what a difference!

  

Week Six - Post op visit and PAIN!

Today was my six week visit with Dr. Royer at Baylor.  I am still non-weight bearing, so wheeled in the office on a walker, pushing with my good foot.  My granddaughters accompanied me which helped tremendously.  We waited in the exam room and Dr. Royer's nurse said that I was going to have an x-ray.  I went into x-ray and 3 different views were taken. I went back to the exam room and Dr. Royer came in a few minutes later and put the x-ray up on the screen.  He said the STAR replacement looked "beautiful". 

X-ray taken today

He said the next plan will be to walk in a boot with my full weight on it and after 3 weeks, another x-ray would be taken to make sure nothing had moved with the replacement during the period of walking.  If all is well, then I will start Physical Therapy.

The Boot

Dr. Royer's nurse took my boot and pulled the wedge out of the bottom, and realigned everything, put me back in it, and told me to stand up and take a few steps.  I took one or two steps and FROZE IN MY TRACKS.  It was painful!  It made me nauseous. It was the same pain (or very much like the same pain) that I had BEFORE my ankle replacement.  Logically, this doesn't make sense because Dr. Royer cut away the bone rubbing against bone to put the new ankle prosthesis in my foot.  Nevertheless, that horrible pain is there.  It is located on the INSIDE of my ankle, around the bone and from the bone down to where the bottom of my foot begins.  It could be the tendons or ligaments ~ who knows?

I immediately told the nurse that I couldn't walk because of the pain, and she said that it was going to be painful  and to remember "no pain.......no gain."   I understand that, and I'm not a lightweight when it comes to pain, so we will have to come up with another plan since it's obvious that I'm not going to be able to wear the boot.  It gave me that darn pressure sore when I didn't have weight on it.

Six Week Photo

I can't take the steps I need to for the weight bearing, so I don't know how I will make it through 3 weeks of trying to walk before Physical Therapy.  Other people who have had ankle replacements have not reported pain in this area.  Another bump in the road, but I will be in touch with Dr. Royer and maybe we can come up with another plan. 

 I must trust God to be my calm in the storm.  He knows the absolute hell I've been through with this foot.. Surely goodness and mercy will follow me because right now I don't know if I will walk again without having pain.  I know that I will be working part time for quite some time because of the swelling.  I believe he said at least two months.

Friends, I realize this is not the most joyous post tonight but like I always say....this is my story.  I'm telling you the reality of every aspect of this experience. Your thoughts and prayers are mighty appreciated!

xoxo.....Jan

Meanwhile....keeping it on ice



Week Five - Thankful? Yes.

This is definitely a better week.  Maybe because I rolled to the laundry room yesterday and threw some clothes in the washer....or made a new necklace on Sunday ... or being thankful that my daughter is a wonderful caregiver - making sure I have everything I need and going way over and above what she needs to do.  Thankful for the Luv and support of my Coworkers, always cheering me on. Thankful that my granddaughters come in the door with laughter, saying, "Hi Grandma" and heading straight to the puppy to love on him and watch his antics. He will have major Mama-withdrawal when I go back to work. Andy is always here by my side and anxious to lick, snuggle and play.

I can tell you all the titles of movies I have watched in the last month and recount all the "Jail" episodes, "Operation Repo", "Hardcore Pawn", "Cops" and every single day of the Casey Anthony trial.  I feel like a secret juror listening to all the testimony.  I have time to lay here to contemplate what I want for lunch and dinner and what t-shirt and shorts I will wear for the day. Taking a shower is my exercise (as well as refreshing).  After a month's experience, I am also pretty darn good at Angry Birds.

When I'm in a thinking mode, I wonder how I will regain my strength.  Will it happen once I start to walk?  Will I get some of it back in rehab?  When will I stop sleeping for three hours and wake up?  How soon will Jenny Craig help me take the extra weight off?  Now, I'm not the only patient with these questions....a few people in the U.S. who have had the same procedure are wondering the same things.  Given that this surgery is all pretty much uncharted territory and we are the new pioneers, wouldn't you wonder as well?

Am I ungrateful?  NO!  Do other people have it worse than me?  ABSOLUTELY! 

I say this only because a long-time friend who I haven't seen or talked to in a very long time, forwarded me an email.  They didn't write a personal message; however, the content was that of not complaining about our circumstances - lest they be worse.  The email regarded a little boy with no legs, being fitted with prosthetic feet and legs and showing his many accomplishments. The little guy was a go-getter!  It was something you would never, ever wish on any child (or anyone). Again, the message was "Don't complain".  I suppose this friend felt that I was whining too much on the last post and decided to throw cold water on my face, so to speak.  (Point taken.)  Then, there was the lady who told me to read "The Secret" (ask and it shall be given) and the guy who played soccer and hurt his knee and gave his advice on healing.  Whew!

The fact of the matter is ....we are all different and this is my experience.  Just mine.  However, if you have been an independent person, you will be confined to a bed, sofa or recliner and at the mercy of others taking care of you and it's not going to be a trip to Disneyland.  It won't be a living hell, but you will have definite limitations for weeks.  The end result of this surgery and limitations are to give you freedom from the intolerable pain which is all the time both day and night.  Freedom to walk without a brace and to walk without a limp.  Freedom to live a more normal life and resume activities that you have given up long ago because they were too painful.

Next week - Six::  Doctor visit and maybe starting some rehab and bearing a little weight on the new ankle?  We'll see ---- I'm ready!

Week Four - Sick of Being Tired!

I promised myself that if I did write this blog, it would be real and whatever I encountered, I would talk about it here and let people draw their own conclusions.  That being said, this is going to be a WHINEY-ASS post. This is not a good week.  It has been up and down with a myriad of emotions.  Logically, I know that I've got to be healing; yet, I am still very weak and depend on someone to bring me food and drink, do my laundry, get out clothes each day for me to wear and empty my trash.  I can go from the walker to the bathroom and back. The weakness in my body equals "no progress" in my mind.

It has me wondering if every total ankle recipient feels this way, or is it just me?

It will be at least 3-4 weeks before I can start to put partial weight on my foot (providing that the ulcer has healed) and then what?  Physical therapy twice a week?  Working part time?  Will I work again?  Will I walk again?  Only time will tell.

I would love the independence of of being able to walk.  I can get nowhere in my walker.  In fact, I have two walkers but I am rolling slow.  Talk about naive.  I didn't believe that this recovery wouldn't be any worse than my original fracture and surgery, but it IS.  I went back to work part time after two weeks in 2009.  Not this time.  Oh NO.  Also, a lady wrote me today and said that she is in her 11th week of recovery and is still tired.  (And I'm in week FOUR.)  And taking a shower exhausts me.  Reading email exhausts me. Sometimes eating exhausts me.  I am sick of staying in bed but I have to keep my foot elevated.  And if I'm out of bed, I'm too weak to sit up and my head starts to pound.  My foot hurts. Have I really been in bed a whole month?  I guess so but the days run together.


At this point, I can not imagine being able to walk on that foot again without pain and without a limp.  I can not imagine wearing regular shoes again.  I want to feel good again, vibrant, with energy. How can that happen?  Go slowly and work up my strength?  My body is screwed up.

Which brings me to my Chiropractor. What would I do without him?   Chiropractors are very under-rated and the huge health benefits of getting a chiropractic adjustment (a GOOD one) is very misunderstood..  I try to see him every two weeks if possible and now it's been six weeks.  I don't trust anyone but his hands manipulating my body. He has the skill to make my aching muscles quiet down and not hurt so much.  I get terrible headaches at times.. He has the skill to crack the heck out of my neck and skull and make the headache go away.  I need an overall adjustment now.  I feel like a grenade has gone off nearby and my entire body feels the impact. 

I have friends that want to visit me and I don't feel up for company.  I can't sit in one place very long at all.  Maybe next week will be a better one.  Dear God, give me strength to make it through this and come out on the other side STRONG in mind and body.

Week Three - A bump in the road....

Today marks the 3rd week since my surgery and one week that I've been wearing a boot 24/7.  I knew I had pain the last two days on the inside of my ankle (the good side - where there were no sutures removed).  I took off my boot and stocking. There it was!  An ULCER. A pressure sore.  A hole in my skin. (If you want to see it, you can look in the Post-op photos page.)  How in the hell did that happen?  Crap! 

I'm not weight-bearing yet but somehow the metal brace on the side of the boot was pushing on the thin-skinned bone of my inner ankle.  This spot is where the two screws were left from my original surgery on January 13, 2009 when the ankle was shattered and put back together.  The screws have always been so close to my skin that I can press on the ankle and feel the head of one of them!  Dr; Royer removed the plate and screws from the opposite side but left those two screws on the inside of the ankle because screws needed to be in there somewhere - to stabilize the bone to support the new ankle - and since I already had these, he left them there.

I'm going to vent now:  I've been "good" and strictly followed my Doctor's orders - "toes above nose" elevation for 3 weeks, slept with my boot on (and I do use the word "sleep" loosely) and haven't put any weight on it.  Still an ulcer. A definite setback. 

When I called Dr. Royer's office and told them what I had discovered, they wanted me to come as soon as I could get there, and it just happened that my granddaughter Taryn was there to take me.  My Doctor was in surgery all afternoon, so we saw his Physician's Assistant.  She said that they haven't seen an ulcer in a TAR (total ankle replacement) patient before. (so...that means I am the first one?!!)  The sore has got to heal soon because I will be trying to weight bear and start PT in 3 more weeks. Which also means.....wearing the boot again.  The PA made an adjustment to the boot and placed foam higher up where the metal brace was eating into my skin, so hopefully when it heals, I won't have that area break open.  They don't want any infection anywhere near the new ankle so I'm taking more Levaquin and using an antibiotic ointment. 

Here is what I'm wearing now - a removable splint (which looks like a cast).  It has a hard shell on the foot and back of my leg.  I can take it off to shower, and wrap ace bandages around it to hold it on my foot and ankle.

So here we are.  I am trying to not let my thoughts overwhelm me and trust me - alot of them are dark thoughts.  My Mother, who was in excellent health contracted a sudden flesh eating bacteria (Group A strep) and lost her life to it.  There was a family friend who died a couple of months ago  from an open ulcer that didn't heal in her abdominal area.  I can't think about this or I will have the all-too-familiar panic disorder creep its way back into my life again. Ultimately, I have got to stay positive and believe that this is just a bump in the road.

As always, your healing prayers are most appreciated!

Week Two - First Post-op visit

Dana took me to my first visit with Dr. Royer since surgery two weeks ago.  I had a rough time with the walker just getting from the house - to the car - to his office.  I had to stop about 3 times and catch my breath.  That's what happens when you're in bed with your foot raised for two weeks straight - very weak. More than I had expected.

We were called back and one of his nurses came in and removed the thick hospital (post surgery) dressing and bandage.  There was a lot of dried blood (more than I had thought). Then when she got to the actual foot -oh, what a sight!  Bluish, reddish purple. I had a perfect straight incision in the center of my lower leg down to my foot.  There is also a side incision a few centimeters under my old one where he removed the plate and screws from the original fracture surgery in January '09.   She said that I was going to have a new cast today, and what color did I want?  After much debate and indecision, we chose the hot pink one.

I was wheeled to x-ray where they took two views of my new ankle and back to the room.  In x-ray the technician asked if I could move my ankle toward me a little, and though it was horribly stiff - it ever-so-slightly moved!  Everything in my left foot feels swollen and tight.

When Dr. Royer entered the room, I hugged his neck and smiled and thanked him!  I hadn't done that yet because I was so groggy in the hospital.  He went over everything with Dana and myself, I told him that I was writing this blog and had connected with other people that had TAR's and he was kind enough to take the x-ray pics that are posted today.  He said if I will bring a jump drive next time, he would put all of my x-rays on there!  The STAR (Scandanavian Total Ankle Replacement) system has only been approved by the FDA since November '10.  I am Dr. Royer's 15th patient using the STAR.  Of course, he has done other types of systems, but this is the latest and hopefully the greatest of them all!  Dr. Royer looked at the x-rays and I saw my new STAR ankle on film for the first time!  Beautiful!  He then examined the sutures and his Fellow, Dr. Ding, removed them.

Everyone was surprise whenI wasn't given a hard cast, but a boot. (Every TAR Surgeon does things differently.)   I have to wear it 24/7 and can take it off when I shower.  I will see him in 4 weeks and be re-evaluated.  The mission now is to have the bone start to grow around the prosthesis.  That is essential for this surgery to be a success. I will not be working during the month of June so I continue to elevate my leg and this crucial healing can continue.  This is my last chance for mobility.

I will post photos but not on this page.  Look at the other pages under "Post Surgery photos" and you'll see all you want.  I pray each day for this total ankle replacement to be a complete success.  I appreciate your prayers too!

Week One - Random thoughts at 4 am

One word ------> Pain.

Who the hell knows what is normal and what's not?  Everything seemed to be doing pretty good with a minimal amount of pain....until Thursday.  I started feeling more.  I was taking a couple of Motrin, now I'm taking two pain pills every 4 hours. This is pain where I can't keep my leg still.  Oh, I expected pain.  But why did it start 10 days after surgery???

Since I have all this time to think, I have come up with a few ideas.  I had virtually no sleep last night.  Why?  Pain and my position.  There wasn't a comfortable one. I had a shower today.  Maybe that's it..  I swear I can feel sutures on both sides of my leg where he must have removed the plate and screws on one side and screws on the other!  I haven't felt the long midline incision yet .... maybe that's still hiding until it rears its ugly head.  Also the cast is HEAVY.  As in very heavy.  I am having a whole conglomeration of pains, sharp, dull, knawing pain, lightning bolt pain. Honest to God, I don't remember the original fracture hurting this much after surgery.  Holy crap. Tri-malleolar, broken like pieces of potato chip, with a dislocation.  Dr. Doom (nasty first surgeon) said, "Well, you can't make chicken salad out of chicken shit."  Thanks.  Wonderful bedside manner while I'm laying up in the E.R. you jerk!!!

And this hour of the morning, pain pills and an anti-anxiety pill, plus different positions aren't helping.  Okay. This is where I have to say it.  It's times like this when I miss Gene.  He would know what to do and what to say to comfort and soothe me.  Can he see me?  Because I sure don't feel him!  I think he would say, "Baby, it's all going to be every bit worth it.  Just hang in there."

I'm hanging.

Sexy Leg all bandaged up

Healing at home

I went home on the morning of the 3rd day post op. I went packing with an antibiotic, pain pills, anti-nausea pills, a spirometer, flowers, bathroom commode and walker. I said my goodbyes to the wonderful nurses that took care of me and two of them wheeled me down to the car. The ride home wasn't bad at all.

I did forget to mention something about the afternoon of the 2nd day.  The pain block thingy that fed anesthetic to my foot wore off suddenly.  I had usually reported my pain level being about a 2 or a 3 on the pain scale.  Let me tell you - it went from a 2 to a 10 in a heartbeat!  I called the nurse's station and asked for something.  It was about 20 minutes until someome brought me a pain pill.  During that time, I lay in that bed and felt like I was in labor!  Relax....concentrate.....breathe......deal with it.......dig fingernails in hand.......close eyes.....are you kidding me?????  I never went without something on board after that.

Today is a day of some sharp nerve pains in my foot.  Even the bottom of my foot.  They go away as quickly as they come and I find that interesting.  None of the pains seem to be where the STAR system is located but if you go to YouTube and search for ankle surgery, you can see where your entire foot is manipulated, twisted, poked, prodded and almost turned inside out.  No wonder there are some pains here and there.  That being said, I rarely take more than two pain pills each day; however, I can supplement with Motrin.

My days are spent reading, watching TV, doing computer stuff, and the #1 priority is keeping that leg elevated high. "Toes above nose." I'm doing it. I want this to be the best surgery and recovery as humanly possible.

Second night not so good

I had some great nurses and nursing assistants in the hospital.  Physical therapy came by early the next morning with a walker and had me walk.  I went to the break room across the hall from my room and back to my bed.  I was exhausted.

I hurt.  I hadn't slept too good the night before.  My foot was elevated very high but my spirits were good and Dr. Royer came by at 6:00 a.m. to make sure that I was going to be laying on my butt at home.  He kept emphasizing that the first two weeks are the most important in the healing process.  "Toes above nose." That night about 12:00 midnight, the night nurse brought me two pain pills and two Ambien for sleep.  Sometime in the morning hours, the nurses ran into my room and said that I needed oxygen because I was throwing PVC's (premature ventricular contractions) of my heart and my oxygen level had significantly gone down.  Once they got me stabilized, I went back to sleep and the same thing happened!  I was afraid to go back to sleep. I think it must have been all the drugs I had that made me not want to breathe.  I didn't take any more sleeping pills after that.  That afternoon, I was on the walker up to the nurse's station and back to my room. I was running a low grade fever for a couple of days from 99.1 degrees to 99.8 degrees.

Tomorrow, it will be one week since surgery.  Only another week to go before I go back to Dr. Royer for suture removal.  I don't know what's next after that, but stay tuned!

The big day arrives

My surgery was at Baylor Medical Center at Uptown (Dallas, TX).  My daughter and I arrived at 5:30 a.m. for the 7:30 surgery.  I had already been pre-admitted and early that morning I just went straight to the surgery suite and checked in, got my hospital bracelets, went over my allergies (again) and gave my consent (again).  While we were waiting, I realized that I wasn't really nervous.  Big milestone for me.  I was ready for this surgery!  I was more excited than fearful.  I kept hearing Dr. Royer's words, "This will be a good thing for you."  I rested in that, and in God.

I was called back to pre-op where I was instructed to take off all my clothes and changed into a large navy blue hospital gown that tied in the back and had a pocket in the front.  The nurse had me put a tight white compression stocking on my good leg and when I was all dressed (or should I say "undressed") she started an I.V. flawlessly, thank goodness!  It was then that they let my daughter come in with me.

[At this point, I have had to ask Dana some details about what followed because I was given some Versed and couldn't remember some things.)

The Anesthesiogist, Dr. Kwan, came in and put some Versed in my I.V.  I didn't feel a whole lot different afterwards except that now I have a little memory loss about some of the events.  Other Anesthesiologists came in and had me roll over on my stomach because they were putting a block in my left leg which would go down to my foot. The Doctor said that my leg and foot would be twitching and moving but not to worry because it would be him doing it.  It seemed like 3 Doctors were working on that leg and they attached a pump of anesthesia via a small tube that would deliver the medication. When they were finished, I turned on my back.

Dr. Royer came in and said Hi and met my daughter.  He asked me which leg we were working on and my daughter said that I lifted my left leg.  (Ha!)  Then he put a mark on it with a Marks A Lot.  (Really???) Soon, they were finished and escorted my daughter out and me into the O.R.  Getting in there, I remember looking around the room and seeing the Operating table.  They asked me to scoot over onto the table, I did, and then the Anesthesiologist put a mask on my face and I WAS GONE.

When I woke up in the Recovery Room, the first person I saw was Dr. Royer.  My first words were "How did it go?"  He said, "It went great."  I was so happy to hear those words.  I didn't feel any pain from the block they had put in my leg and after a while, my daughter got to come in and see me.  Soon, I was transferred to my room.  I had a huge bandage around my foot and leg with a drain and with a board and foam that I can feel in the back. Cotton is stuffed all inside to make it very tight and yet cushy.  In my room, I was offered morphine via a pump but I declined it.  I have had morphine before twice and it makes me throw up, so I opted to take Hydrocodone.  It worked like a charm without the nausea.  After I was settled, I realized that I had a very dry mouth and I was extremely thirsty.  Also, I had a very bad sore throat.  I asked the nurse if I could have something for my throat pain and she suggested that I suck on ice.  It was from the tube that was down my throat during surgery.  I drank all kinds of liquids, and soon ate jello and had a normal meal that night. I felt a few twinges of pain in my foot that first night but luckily I had my little anesthesia pump that would deliver some numbness to my foot.  I used it religiously.  Soon it was 11:30 p.m. and was still awake watching TV and a sleeping pill was offered and I took it.  Now the thing about hospitals, you are awakened about every 3 hours for vitals.  So I had sleep, but interrupted sleep.  Thus ends the big day of surgery.

Setting the date

I had originally set the date of my Total Ankle Replacement for sometime in the first week of January 2011.  Unfortunately, I had to have a hysterectomy on December 8, 2010 and had to be away from my job a month, so that meant the ankle surgery would have to be postponed.
When I got back to work in the first week of January 2011, I called Dr. Royer's office and scheduled a new surgery date.  It was to be May 4, 2011.  I remember writing the date down on the whiteboard in my office "Jan's Surgery May 4th" so it would be a constant reminder that the date was set. 

Meanwhile, I did research into Total Ankle Replacements and support groups and found one.  It is called Blessed Ankles and there are alot of nice people who have had their own experiences in this.  The constant message I heard in this group were the famous words "toes above nose" immediately after surgery.  I would come to hear this alot in the upcoming months.

I'll back up a bit and tell you a little bit about the ankle/foot orthosis brace that I wore for many months, just to be able to walk.  It was pretty lightweight, but got hot in the summer because it covered my entire leg in the back and came up to the knee. Also, I had to get two pairs of shoes.  I wore a size 8 on my "good" foot and a size 9 on the foot with the leg brace.  Knowing that this was going to be temporary - even several months ago, I only bought two pairs of tennis shoes.  One white pair, one gray pair.  And I wore these shoes over and over and over.  What I would give to be able to wear normal feminine shoes again!  Every now and then I would wear a pair of flip flops to actually see painted toenails but they were off within a few hours.  I was simply hurting too much without the brace. I was embarrassed to wear shorts and capri pants because of that awful brace showing, so I wore long pants.  Always.

The last two weeks before my surgery, I trained everyone in "what I do" at work, because it would be at least 4-6 weeks before I would return.  Finally, I was ready for my life-changing surgery.

All roads lead to Baylor

After having made up my mind that I was going to find an Orthopedic Surgeon that practiced at Baylor Hospital in Dallas, I found something online about Orthopedic Associates of Dallas.  I called to see if they could get me in for a consultation ASAP, which they did. I had an apppointment with Dr. Christian T. Royer two days later!

I went to the appointment where they had me fill out medical history forms and I also brought my x-rays from Dr. "Doom" with me. (Note:  See post below this one. It will explain who Dr. "Doom" is.)  The nurses said they didn't need to see them because they were going to take their own complete set of x-rays. What was different with their x-rays?  They had me stand up on a platform.  They didn't do this at the other place!  I made a mental note: Already much more improved and state-of-the-art over here!

After waiting for just a short while, a man enters who announces himself as one of Dr. Royer's Fellows. What the heck is a "Fellow" you ask?  Webster's dictionary defines a "medical fellowship"  as the period of time spent practicing a specialized field after graduation. (It is an honor to be chosen for this position, and is considered a very good mark on your credentials.)  He got some more information from me, and said that Dr. Royer would be right in.  Another mental note:  They don't waste time over here!

Dr. Royer entered the room and I genuinely liked him from our first meeting.  He is a tall, slender man with dark hair, a friendly smile and a cheerful disposition.  He looked at my x-rays and we talked about my injury, the original surgery, what had developed and I told him what the previous prognosis was and that I felt my options were very, very limited. He suddenly looked very serious, as if he were deep in thought and I will never forget his next words as long as I live.  He said, "I think you would be a perfect candidate for an ankle replacement!"  A what???  I had never heard of this and it certainly wasn't ever brought up as an option before. He said that he was certain that I would be in a lot less pain, a lot more mobile and that I could do anything I wanted --- except run on it.  Why not run?  There is a greater chance of it becoming loose, shifting, and needing a revision.  Ok. No running. That was fine with me! 

Dr. Royer was very confident and reassuring that this was the answer for me because hopefully, I have alot of years left in this body.  He told me to take home some information and consider it and I told him that there was no thinking to be done - I was having it.  One more thing...he also smiled and said that he was prescribing me pain medication, signed paperwork for a Handicap Parking permit and HOPE!  Thank you Lord Jesus!!!  I left his office with a newfound purpose and resolve - I was going to be having a total ankle replacement!