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.