Ankle Replacement and Subtalar Fusion Updates

As some of you may know, last January I had subtalar fusion in my right foot...this is after having a total ankle replacement in the same foot a year prior (Dec 2013). I also had total ankle replacement in my other foot prior to that (June 2013). To read about my ankle replacement journeys, please click here. Below are my updates...

A short summary of the Ankle Replacements...

Going into my ankle replacements, I was very hopeful. My surgeon told me that the replacement surgeries would take all the pain I was experiencing in my feet away. Did it? Well, not really. The best thing to come of the surgery is that my “bounce back time” has greatly improved. Meaning that if I overdue it today, I usually get a restart tomorrow. Before the surgery it would be days. And a couple times I overdid it so badly that it actually took several weeks...meaning that I either could barely walk on it, or, on better days, I was using a cane to get around. So that's the major pro of having the total ankle replacements.

The negative effect of the ankle replacement surgeries is that I can only stand or walk around for about 10-15 minutes before I'm completely done for the day. This is extremely frustrating and severely limits me.

Subtalar Fusion time...

Because I was so limited, I went ahead with the subtalar fusion in my right foot in January 2015. My surgeon said that I still have a lot of arthritis in the rest of the foot (really, both feet) and this may give me some relief. I wasn't as hopeful going into this surgery, but I was trying to remain optimistic. I knew it would be a much longer recovery time, but I also knew I could soldier through if it meant making a difference in my pain while walking/standing. The plan was that if this worked, I would get the left foot done after the right was was completely healed.

When I saw my surgeon last, in September, he told me that I needed to give the fusion a full year to heal before passing judgment. Well, in another week it will be a full year. This is my judgment...I've wasted the last year trying to rehab from the subtalar fusion and it is no better than before the surgery. If anything, it's more painful when I walk.

I've been putting this blog post off for a while now. I guess I was hoping that things would turn around and my ankle would suddenly start feeling better. I hate sounding so negative, but I need to be honest in hopes that it may help someone else.

Not every surgery is going to be a success for every person, and I know that with my SED it makes everything way more complicated than the average person. Up until this point, I've been very lucky with my surgeries. But the past three surgeries (both my ankle replacements and now the subtalar fusion) have been a let down for me, especially the last one. To think that I've wasted the past year is a hard pill to swallow and it depresses me whenever I think about it.

But, things could be worse. At least I have my feet. At least I can walk. I have a supportive family and a husband that is a superman for me. And my kids are 90% of the time, pretty awesome (they're teenagers, so that accounts for the other 10%!)  And I have this squooshy face to cheer me up... 

What does the future hold? I'm not sure. I know I won't be having subtalar fusion in my other foot, unless all of a sudden that foot starts to hurt worse than the other. I may have to look into a scooter sometime in my future (God help my local public!). 

Mostly, I'm hoping for a miracle breakthrough in medicine...where they can grow bone back and instead of giving you metal and plastic replacements, you'll get a new and improved bone instead. How cool would that be?

The Seated Scooter—Non Weight Bearing Option

As most of you know already, my whole body suffers from arthritis, and recently I've been having problems with my right thumb. When you are NWB (non-weight bearing), your upper body really has to do a lot more work than usual. There is increased pressure on your hands, elbows, and shoulders when using a walker or crutches to get around. In anticipation for my surgery next week, and having to be NWB for 6 weeks after my sub-talar fusion surgery, I ordered a scooter to help me get around and take some of the pressure off my upper body.

 This is what I ordered... Roscoe Medical Gemini Scooter With Padded Seat  I ordered it from Amazon (shocking, I know...seriously, I buy everything from this place!) for about $340, which is more than the wheelchair I bought a couple of years ago! Most people that have to be NWB for some time get knee walkers to make getting around a little easier. Here is an example of a knee walker: Roscoe Knee Scooter  Those are a great option for many, but because I've had my knees replaced, it would cause me a lot of pain to use one. This seated scooter is a similar idea, except it has a seat instead of a platform for your knee (fyi...my scooter has a knee attachment, just in case you want both options).  Many thanks to the person who originally posted about this option on my ankle replacement forum several months ago...wish I knew about it sooner!

So, fingers crossed that it helps! And if it doesn't, well, my son thinks it's the “best toy ever”, and has been riding it around the house for the past few days. The night my husband put it together (it took about 5 minutes—no tools needed), my son's response was: “This thing is epic! ...can I have one?”

You think he'll let me use it? You know, for medical reasons? I'm hoping I can get my wedge back...currently that's being used as a back prop for easier tv watching while in bed :)

Ankle Update and Sub-Talar Fusion Surgery

About a month ago I had my 1 year check up for my right ankle replacement, and my 18 month check up for my left replacement. My surgeon says that the replacements have healed nicely and are doing great. Of course, this doesn't explain why I still can't be on my feet for longer than 10-15 minutes without being in an incredible amount of pain. My orthotics have helped some, but not to the extent that I was hoping for. I told him that my goal for the ankle replacement surgery was to go grocery shopping again. Something as simple as walking around the store for 40 minutes or so and coming back home and unloading my groceries isn't too much to ask. I really thought that the replacements would give me the ability to do this...that never happened. 

Apparently I have too much arthritis in my feet joints and bones (there are a lot of them in there!), and this is what's causing all the rest of the pain. The sub-talar joint is one of the large ones, and by fusing this, there is the hope that most of the pain I'm experiencing will be relieved. I'm very skeptical, mostly since I thought that the ankle replacements would be the solution to all my foot/ankle pain. Oh well, let's just all pray that this surgery isn't too hard on my body and that it really does help. I'm not asking to run marathons...I just want to go grocery shopping! God, I'm so easy to please :)

The biggest question (other than, “will this really work?”) was, “how much movement will I lose from the fusion?” Doc says that the sub-talar joint allows minimal movement in the foot and that any movement that I did have is probably gone due to the arthritis. Oh, goody. He said that I shouldn't notice a change in my gait or my walking, and, if anything, my walking should improve since I will have less pain. As it is now, I really feel like I start limping a bit on my right foot when the weather is bad or when I've been on my feet for about 10 minutes...pretty much whenever it hurts...which is often.

The surgery itself is a 20 minutes surgery, and isn't as invasive as my replacements were. That's the good news. The bad news is that I have to be nwb (non-weight bearing) for 6 weeks while in a cast, and then in a walking cast for another 6 weeks after that. Fuck my life. I hate being nwb. And I hate casts. And this is only for my right foot. And I'll eventually have to do this again for my left. Fuckshitpiss

Mini-rant over.

My son says I need an exo-suit. An exo-suit is an exoskeleton suit that allows people to move and have superior strength powers. Sadly, these are only available in the virtual world of video games! However, I think he has a great idea with this...medical community, ARE YOU HEARING ME? I NEED AN EXO-SUIT FOR THE REAL WORLD!

If anyone has any other questions that I haven't addressed, please comment down below. I have a public blog, so don't ever feel like you are prying. I want to get as much information out there in hopes that it will be helpful to someone someday!

Wish me luck, send me some good vibes, and keep me in your prayers!

 

Total Ankle Replacement 1 Year/6 Month Update – Good News And Bad News

Yesterday I made the trek into DC to see my surgeon for my 1 year (left ankle) and 6 month (right ankle) check up.  My original appointment wasn't for another month, but considering the pain I've been in, and the lack of progress, they wanted to see me earlier.

If you've been following along with my progress, then you know that I've plateaued in the past few months.  Since March, I haven't been able to do more than 10 minutes on the treadmill without being in a ton of pain.  Seems like 10-15 minutes on my feet is the absolute most I can do, and by then I'm hurting like a mofo.

 

 

The Good News

My ROM (range of motion) is great.  And looking at some newly taken x-rays, it seems like the implants are healing up nicely.  Everything concerning the ankle joint is perfect.  My surgeon was very happy with his work :)

I explained to my doc that I still can't be on my feet for more than 10 minutes without being in pain and asked why that would be.  And then came the bad news...

The Bad News (with a little Good News (sorta) sprinkled in)

The bones in my feet are shit!  Because of my condition (SED—aka: shitty bone disease) I have severe arthritis in my feet.  I'm looking at future surgery on fusing a few of these bones in order to help with the pain.  When I heard the word “fusion” I freaked out.  At first I thought he was talking about fusing my new cyborg ankles that I just busted my ass for a year to get to work right.  But he assured me that it's not my ankles he's talking about, but my feet.  Apparently ankles and feet are separate things...duh! :P  Doc says that fusing the bones in my feet won't affect my ROM because any ROM that I would have had in these bones is already gone.  I asked if my walking would be affected and he said that it would probably be better since I won't be in pain.

The circled pen marks are the spots where he'd do the fusions.

Now, he won't really get into the knitty gritty of the surgery just yet.  He wants to see me back in 6 months for my one year anniversary on ankle #2.  If I'm still having pain at time, then I'm thinking this foot-bone-fusing discussion will happen then.

So I'm looking at another surgery in the near future, but it should help with my pain...that's the sprinkle of good news just in case you missed it :)

What do I do now for my feet pain?

He's hoping that my new orthotics will help relieve some of my pain.  Since I've only had them a week, it's still too early to tell.  My husband asked how long it would take to see some improvement with the orthotics and Doc said for a “normal” person it usually takes about six weeks...but for me he thinks I'm looking at a couple of months.  Either way, this is a longer time frame than Ryan (the orthotics fitting dude) gave me.  Oh well.  Fingers crossed!  Anyone else have orthotics?  If they've helped, how long did it take for them to start helping?

Doc is also prescribing some compound pain cream to rub on my feet twice a day.  I have some pain cream that I use on my neck (to read about my neck problems click here) and this sounds like a similar cream.  The cream I have helps with my neck, so hopefully this new one will help with my feet.

I'm also supposed to start actually taking my Celebrex twice a day as it's prescribed.  On the bottle, it says to take one pill once in the morning and once at night.  Well, I try to take as little medicine as possible so I usually only take it at night.  I guess now I'll change it to twice a day and just suck it up!

Figuring it couldn't hurt to ask, I asked if cortisone injections would help at all with the foot pain.  Doc basically laughed out loud.  Apparently my bones are so shitty that they'd react to cortisone with a "bitch please!"  Oh joy!

At least I have some answers now as to why I haven't been getting any better.  It's always worse when you don't know what's wrong.  Don't you think?

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To read about my full ankle replacement journey, please click on the Total Ankle Replacement tab.  

I'm happy to answer any questions that you may have.  Please comment below, or email me privately at:  thecyborgmom@gmail.com

My New Custom Orthotics...The Jury Is Out

I got fitted for my custom orthotics a few weeks ago (you can read about my fitting here) and was finally able to pick them up this week.  Figured I'd get pictures before they get all gross and stinky.

Here they are with my Easy Spirit sneakers in a size 6, which is a half size bigger than I normally wear.  They easily go in and come out.

The top of the orthotic (the black part) feels soft.  The part where the toes are is very flexible.  The rest is pretty rigid.

This is the bottom...the white part is the heel.  

They feel kind of weird, but not bad...just different.  I have to give them some time before I come to a decision about them.  The only other pair of shoes that I've tried them with is my Sketchers sneakers, which are my usual size, a 5.5.  They fit inside them okay, but my feet fit really shallow.

The good news is that "right" and "left" are printed on the bottom, along with my name...so I feel a little bit like a kindergartener :)

I go to see my ankle surgeon this Friday for a post-op check up and to see what's going on with my lack of progress.  I'll do an update post next week to keep everyone informed!

Going For A Road Trip

My stress level has been pretty high over the past few weeks...with dealing with my plateaued progress with my ankles, and some upcoming family events.  But this past weekend I noticed my anxiety getting markedly worse than it's been.  This upcoming weekend we are going out of town for my brother-in-law's wedding and I'm really dreading the whole trip.  Don't get me wrong, I love my BIL, and my future SIL, and I'm happy to attend their wedding, it's all the other stuff that's a problem for me and my medical state these days.

The only long trip I've made in the past year was when I went to visit my parents in Delaware back in November.  Visiting them is a 3 hour car trip each way, and although it took a lot out of me, there was nothing expected of me.  We didn't go anywhere...I could wear my sneakers...I could put my feet up when needed...and I knew that if I didn't feel well, I could always go and lay down and rest.  Bottom line...I didn't have to pretend to be happy and well if I really wasn't.

 Most people don't realize how much pretending, or putting on a happy face, goes on when you are a chronic pain sufferer.  Even the simple question of, “How are you?” is a difficult one to answer.  Are they just making conversation? “Okay, and how are you?”  Do they want the short version of the truth? “I've had better days, but things could always be worse.”  Do they want the whole truth? “I want to go home and load up on pain meds until I fall asleep and don't have to deal with the pain any longer.”  By the way...I usually go with the short version answer so I don't have to freak people out and make them feel uncomfortable.  Aren't I nice? :)

This weekend allows me a limited amount of options.  Not only is it a longer car ride, but I can't wear my sneakers, I can't put my feet up, I have to go about things on my own (without my husband's help since he's in the wedding party), and I can't just leave and lay down if the pain gets too much.  Not only will I be bringing all my pain meds along with me for this trip, but my Xanax for the stress of it too.  It's amazing how much more anxiety I get when I feel like I'm backed in a corner and have no plan B.

Say prayers for me my friends!  I have a feeling the anxiety is only going to get worse.  Hopefully the pain will be less than the anxiety, although I have a feeling it probably won't :(

Total Ankle Replacement: 24 Weeks Post-Op--Ankle #2

If anyone is following this blog because they are interested in my progress, and you are looking for some updated stats...look at last months stats and add five pounds to the knee machine and ten pounds to the leg press machine. That's all the progress that I've made in four weeks time :(

This week marks 24 weeks since I had my total ankle replacement on ankle #2. Ankle #1 is almost at the year mark (June 12). Last month I talked about how I don't feel anywhere near “normal”, and I'm starting to think that I'm never going to even come close to that at all. The past four weeks have been very depressing as I've realized that I've plateaued in my recovery for the last couple of months. Now, I've had plateaus happen before with other surgeries, but it's usually for just two weeks or so. Looking back at my progress in my March posts, I realize that although I've gained more strength in my legs, I haven't gained any endurance at all. At all. I can't stand on my feet longer than ten minutes without being in a terrible amount of pain. I'm starting to think that this isn't going to get any better.

Whenever I mention this to anyone, they remind me that I'm only about six months out and this can take a year to eighteen months to fully recover. But I'm almost at a year with my left ankle (#1)! And that is not any better than my right! They are in the same level of shitty pain!

Getting fed up.

I've had both hips and both knees replaced, so this replacement thing is not new to me (I told ya I was a cyborg!). I know that rehab is painful, but after it's done, the benefits can be life altering. My hips were so bad that after I had my replacement surgery I felt like I hit the jackpot. The replacement hips were new and improved and better than the originals (they took about 3 months to rehab). And although my knee replacements were a bitch to rehab...by far the worst pain I've ever encountered....the trade off was that I was pain free after all was said and done. The biggest downside to my knee replacements was that I lost a lot of range of motion (ROM). This is always a possibility, and I knew that going in for my ankle replacements. But I was willing to trade off ROM for no pain...no such luck. My ROM for my ankles is within normal range, but there is still so much pain whenever I stand or walk.

I'm not scheduled to see my surgeon until July. I think I may call just to ask if I should be worried, or if I need to be seen sooner. Can't hurt to ask, right? Only thing is...what if they tell me that this may be it for me? I've been so depressed over the past few weeks, that I don't know if I want to hear bad news right now.

Both the hips and knees, after rehab, gave me a (mostly) pain free existence in those joints (there's the occasional "I feel the rain coming"). I just assumed that I'd have a similar experience with my ankles. This is not the case, yet, and I'm starting to lose hope.

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To read about my full ankle replacement journey, please click on the Total Ankle Replacement tab.  

I'm happy to answer any questions that you may have.  Please comment below, or email me privately at:  thecyborgmom@gmail.com

Arizona Braces and Custom Orthotics

Monday morning I had my appointment to get fitted for my custom orthotics.  So, in other words, I'm full on my way to being a grumpy old lady ;)

I went to the same place, and had the same dude, that I got my arizona braces (AB) from.  Those arizona braces basically held off my ankle replacement surgery for about two years.  Wearing them helped me to stay on my feet just a little longer because they work by simulating a fusion.  They're not the most comfortable things to wear, but without them I would have been so much worse than I was.

For those who have never seen these braces in person, they are made of a rigid plastic and covered in leather.  The inside, where they touch your leg, has a thin foam layer.  You put them on (with socks, or they will end up stinking to high heaven), lace them up, and then wear them with a rigid shoe...I sized up a half a size, took out the insoles, and wore them with sneakers.  The worst part for me was that they got very hot in the summer and I even ended up getting athlete's foot and had to treat my feet with over the counter spray.  Yeah, not so sexy.

Looking at the picture, you may ask, "why are they different?".  One is taller than the other and the heels are different on them as well.  The only answer I have is that since these are custom made, and I had them made about a year apart, they will vary.  I do think that the one that did not have the rigid plastic on the heel was more comfortable than the other.  At times my right heel would go numb because of the plastic.  So if you have to have these made, ask for a soft heel.

When I was fitted for my ABs, it was all very hi-tech.  I placed my foot on a stool and then the tech, Ryan, used what looked like a grocery store scanner to “paint” my foot and leg with the laser.  The images came up on the computer and are then sent to whoever makes them.  It takes about 2 weeks for them to come in.

Getting fit for my orthotics was different.  No laser beams that look like a scanner.  Instead, I had to place my foot into this blue foam.  Actually, Ryan took my foot and gently placed it in there and then pushed down on my toes and in the correct places on my foot to insure that I had a perfect footprint.  The foam felt like I was stepping in sand, but when I took my foot out it was all clean...no debris left.  I did this for both feet and we were finished in about 5 minutes.  Easy peasy.  Like the ABs, they should also take about 2 weeks to come in.

As a kid, I had custom orthotics made for my flat feet.  They were horrible and very painful to wear.  I asked Ryan if my new orthotics would be like those, all the while hoping that in the past 30 years that medical science had greatly improved in this area.  He said that they don't even make those kind anymore because they were too rigid.  Thank God!  Ryan said that the new ones will be firm, with a thin padding on top.  I'm just hoping that they will fit into shoes other than sneakers.  I've been confined to sneakers for the past 3 years or so because of the arizona braces.  I'd really like to wear some boots!

I miss my boots!

Total Ankle Replacement: 20 Weeks Post-Op--Ankle #2

So this week is 20 weeks since I had my total ankle replacement on ankle #2.  I still don't feel “normal” in either of my ankles (ankle #1 is approximately 10 months post-op).  I realize that there's a very really possibility that I might not ever get to “normal”, but I've been pretty disappointed about my level of progress so far.  My husband keeps on reminding me that it hasn't been that long with either ankle and that I just need to be patient and give it more time.  But...patience is stupid.  Just getting frustrated here!

Physical Therapy/Medical Gym

Since last week, I've stopped going to physical therapy and have progressed to the medical gym.  What does this mean?  Not much.  Basically I do all the same exercises that I did while in pt, but I don't consult with my therapist anymore.  I'm lucky that my pt place allows patients to transition to a gym routine like this and I'll probably keep this up for another month or two?  Who knows.  I guess it depends on my level of progression and frustration factor.

I stopped using my aircast ankle brace a few weeks ago while at the gym.  I still wear it whenever I go out, but not at home.  Most of my exercises have remained the same, with the weights changing for some.

Hip machine...45lbs (same as last month)
Knee machine...25lbs (up from last month)
Total Gym...level 6 (same as last month)
Leg lifts...3lbs each leg (same as last month)
Leg Press machine (this is new)...60lbs
Pilates Reformer...
     Heel on bar squats w/ foot flexed... 1 red band (same as last month)
     Toes on bar squats w/ foot pointed... 1 red band (same as last month)
     One legged squats... 2 red, 1 green band (same as last month)

I stopped doing the rebounder every time.  Instead, I've been balancing daily at home...either barefooted, or with my Birki's on.  My balance has much improved!

Unfortunately, the treadmill hasn't progressed as much as I'd like.  I'm doing 10-12 minutes at 1.3mph.  Seems like whenever I'm on my feet for longer than 10 minutes, I start to really hurt.


Range of Motion
My range of motion is pretty much the same as it was last month.  I hope to do a video sometime in the next few days and will link it here.

'Round the House

Still walking with a bit of a limp, which is way more noticible the more tired I am or the more activity I have done.   I can load and unload the dishwasher, do the laundry, and vacuum (one room before I need to sit and rest).  I really try to schedule cleaning time so I don't overdue it and kill myself for the day.  I can cook a little bit...I sit on the counter if I have to be at the stove.  I cannot do a whole big meal, with lots of prep, and the cleanup afterwards.

Out and About

I'm still pretty sore on the days that I go to the gym in the morning and try not to schedule anything for the rest of the day.  But if push came to shove, I'd just slap my aircast on and maybe take a pain med if I really needed to do something super important. 

Like I mentioned above...I still can't really be on my feet longer than 10 minutes.  After that time, my feet start to massively hurt.  I did make a trip last week to Kohl's to get my son a new suit.  We went in, got some clothes to try on, and I sat down in the dressing room to rest while he tried on clothes.  All was going well (up to get clothes, sit down to rest) until I asked a sales lady to check the back for some stock.  We waited about 10 minutes (my breaking point), and then I had to wait another 5 minutes (at least) on the line to check out.  Holy hell...I was in so much pain by the time I got home.  I barely made it out to the car and could hardly walk the rest of the night.  But the next day I was okay, which is a huge improvement.  Before surgery, I wouldn't have been able to walk for days.  I did take a pain med when I got home, and it took the edge off, but I still could barely walk.

Immediate Goals

Over the next month my biggest goals are:  to go to the elementary school to have lunch with my son.  This was a goal for last month that I just haven't had time to do.  

I wonder just how far behind I am than the average person having this type of surgery...if there's anyone out there who can compare, please comment below!

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To read about my full ankle replacement journey, please click on the Total Ankle Replacement tab.  

I'm happy to answer any questions that you may have.  Please comment below, or email me privately at:  thecyborgmom@gmail.com

Total Ankle Replacement: 16 Weeks Post-Op ROM Measurements Ankle #2

While at physical therapy today I asked my therapist to take some measurements since it's been a while.  The following are my passive range of motion (meaning my therapist can push my ankle to these measurements) numbers for my right ankle:

Plantarflexion                50

Dorsiflexion                  12

Inversion                      35-40

Eversion                       12

The inversion number shows a range from 35-40 because Jenn, my therapist, wasn't writing the numbers down as she did them and she remembered it being 40 and I remembered it being 35.  She said there is a +/- 5 degree error on the measurements anyway.

Click here to see my pre-op and 9 week post-op measurements.

The biggest difference between my numbers from seven weeks ago is the increase in my plantarflexion measurement.  This doesn't surprise me.  I've been working hard to get the flexibility back and even when I'm pointing my toes on my own, I can get more motion than my other foot (I know this is because I was able to start physical therapy a lot earlier than I was for ankle #1).  Hopefully, as my leg and foot muscles get stronger, my active plantarflexion (how far I can bend it on my own) will get even more.  If not, Jenn assures me that all my measurements, for both feet, are within the “normal” range.

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To read about my full ankle replacement journey, please click here.

Total Ankle Replacement: 16 Weeks Post-Op – Ankle #2

So today is 16 weeks since I had my total ankle replacement on ankle #2 and things are coming along pretty well.  I still don't feel “normal” in either of my ankles (ankle #1 is approximately 9 months post-op).  But there's a very really possibility that I might not ever get to “normal”.  I'll settle for pain free and working :)

Physical Therapy

I'm still going to physical therapy twice a week to regain the strength in my legs and feet.  At physical therapy I'm doing between 10-12 minutes on the treadmill...still at a snails pace.  I'm up to 45lbs on the hip machine, 15lbs on the knee machine, and level 6 on the total gym.  This is all with the aircast ankle brace on ankle #2 (for pics of my aircast click here).  My therapist also has me doing some weird exercises on the reformer (pilates machine) with my shoes and brace off.  I guess this torture is supposed to help strengthen the smaller muscles in my feet.  And last week the rebounder was added into the mix...that's the one where you throw a weighted ball at a mini trampoline and it bounces back and you catch it.  What does this have to do with my ankle?  Yeah, I have to do this exercise while balancing on my bad foot.  I've yet to master just one toss.

My range of motion is pretty much the same as it was a couple of months ago...seems like I got it all back pretty quickly (click here for my last post with measurements).  The biggest difference is that when I flex my ankle up, I can make it go further now on my own (this is my active dorsiflexion...for those that know all those fancy pt terms).

'Round the House

My gait is continuing to get better, although I'm still walking with a bit of a limp, even with the aircast on.  Without the aircast, the limp is much more noticeable.  I wear it whenever I go out, but when I'm at home I don't.  The one exception is when I had company over for my birthday...I wore my aircast in the house since I thought I would be up and about a bit more.  It definitely gives me a bit more stability than without it.  And, thankfully, it isn't as annoying to wear as it was in the beginning.

Out and About

Yesterday was the first day that I went out in the afternoon after having pt in the morning.  Usually on pt days, I don't schedule anything for the rest of the day because I'm so sore.  But yesterday we went out to dinner after I took my son to the orthodontist.  By the time we got home last night I was pretty sore, especially since I drove.  But waking up today I was okay.

If I'm out for the afternoon then by the time I get home both my ankles are swollen.  To be fair, this was like this even before the surgery.  I was hoping it was going to get better, and maybe it still will, but it hasn't yet.  I've yet to make a grocery store run...that's my biggest goal...to go the grocery store and not regret it for days afterward.  It's the little things!

Immediate Goals

Over the next month my biggest goals are:  to go to the clothing store with my daughter for some needed items, and to go to the elementary school to have lunch with my son.  The clothing store run will have to be short and sweet...luckily my tom-boy daughter would rather be doing just about anything else but shopping with her mom.  And I have to get in all the school lunches that I can with my son before he goes to middle school and wants nothing to do with me :(

I wonder just how far behind I am than the average person having this type of surgery...if there's anyone out there who can compare, please comment below!

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To read about my full ankle replacement journey, please click here.

My Cocoa Butter Slathering Routine

Years ago, to help with scarring, I used Vitamin E ointment when I had my hip and knee surgeries.  At the time, I thought it helped a bit.  But most scars really need time to help them fade.  And time requires patience...and I really hate patience!  I want my scars to fade yesterday.  So this time around with my ankle surgeries, I decided to try something new.

I had used cocoa butter on my c-section scar way back in the day when I had my babies.  It was supposed to help with scarring and stretch marks.  Did it work?  At the time, I wasn't really sure if it helped a lot, but I did think it helped a bit with the scarring.  Not so much with the stretch marks :(  So I bought a new jar of cocoa butter before ankle surgery #1 in hopes that it would help lighten my scars.  And the Palmer's brand even had my previous go to, the Vitamin E, in it.

For my first ankle surgery, which was in June 2013, I put it on in the morning and at night every day for a few months.  I haven't been quite as diligent with ankle #2, but I do put it on every day...just not always twice a day.  Lately, I've been applying it to both ankles...I figure that it can't hurt to continue on both...especially since I have so much of it left.  Seriously, this stuff goes a long way.  I have a 3.5 oz container and considering how often I've used it, there is still a lot left in this little jar.

It is more of an ointment than a cream...meaning that it doesn't fully absorb into the skin.  When I apply it, I do so right before I put my socks on.  But even when I apply it at night, without socks, I don't find that it's a problem...it's not super greasy or anything.  If you go to my picture page, you can look at my left and right ankle scars and see the difference between the two.  The scar on my left ankle (#1) is very light considering the short amount of time I've had it.

And the best thing about cocoa butter...it smells very good...like chocolate.

Has anyone else used cocoa butter for scars?  Any other recommendations for products that work well for scarring?

12 Week Update -- Ankle #2

This week has been a really transitional week for me because even though I'm progressing by being out of the walking boot, I've slowed down a bit because it's a lot harder on my ankle to be in the aircast.

I saw my ankle surgeon on Friday morning and got my boot off and fitted for an aircast ankle brace.  (You can read about my whole visit here).  I'm supposed to be weaning myself off of the boot and into the aircast over the next week or two.  Well, I've been bad.  I really don't like the aircast...it's very uncomfortable to wear, even if I'm not walking in it.  I find it too constrictive.  So, for the past few days I've been walking around the house without anything...at least most of the time.  I have been using my cane when I don't have the aircast or boot on.

I went to church on Sunday with my boot on and then came home and put the aircast on for the rest of the day because we went to my in-laws.  I wore the aircast on Monday to physical therapy and then wore the boot at home on and off the rest of the day because my ankle was really sore and the thought of putting the restrictive aircast back on wasn't an option.  Tuesday and Wednesday I didn't wear the aircast or boot at all with the exception of when I had to go out and drive to pick up my daughter from school.  I know I should be wearing it, but I just find it really annoying.

The best news of the week:  I can drive!!!!  Granted, I can't drive far, or for long, but I have a little bit of my freedom back.  The bad news is that I have to wear my brace for driving...at least for the moment.

My goal for the month of March (basically the next 4 weeks)...to be able to go to my son's school and have lunch with him.  He's at that age where soon he won't want to have lunch with me because it will be the most embarrassing thing on earth to have lunch, in public, with his mother.  My kids are growing up too quick!

My Top Of The Line 3 Part Ankle System

Someone recently asked me about the size of the implant that was used in my ankle.  So I asked my surgeon if he remembered or knew.  He said that he didn't know, but that if he had to guess, it was probably a small size.  He also said that the decision on which size implant to use is made when the patient is on the table.

My implant is the STAR implant--Scandinavian Total Ankle Replacement.  At the moment, it's the top of the line, most advanced ankle in the world.  It's a 3 part system...2 metal parts go into the bones and there is a plastic part (that you really can't see on the x-ray unless you look really hard and see what looks like a thin pin) that acts like the cartilage.  He said that the 2 metal parts come in 6 different sizes and the plastic part comes in 8-10 sizes...so the entire thing is very custom.  I'm like a custom built Buick :)  The nice thing about the three part system is that if one of the parts starts to wear, it can be replaced without the others having to be touched. 

I asked if the plastic part was the most likely piece to wear first because it acts like cartilage...he said yes.  And get this...he said that it's a 5 minute procedure to replace that part because he's just making an incision large enough to pop out the old part and put in the new one.  I wonder if they even need to put you under general anesthesia for that?  The way he explained it, it sounded easier than when I had root canal!  Have I ever mentioned my hatred for all things dentist related?

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To read about my full ankle replacement journey, please click here.

11 Week Post-Op Surgeon Visit

Hauled myself into DC this morning...well my husband actually did the hauling as I still can't drive (yet).  I'm 11 weeks post-op and I'm progressing on track.  My doctor ordered more x-rays to be taken and things are healing up as they should.  I was given a prescription for another 4-6 weeks of physical therapy...which is great since I still need to build up my strength and work on my balance.  My next post-op checkup with the surgeon will be four months from now...which will be approximately 6 months for ankle #2 and my 1 year anniversary for ankle #1.

I'm allowed to start progressing out of the boot and into an aircast, which they fit me for and provided me with today.  This is the same routine I did with ankle #1.   I'll wear the aircast around the house a bit and see how well I tolerate it.  I will need to work up to wearing it all the time.  The aircast they gave me today is a size small (I wear a 5.5 shoe) and feels a bit snug.  I'm hoping that it will “break in”.  I had a medium for my left (ankle #1)...maybe because I was more swollen when I was fit for it.  I do remember the brace feeling uncomfortable when I started wearing it last time around too, but not this uncomfortable.  I'll give it a few days and see if it improves.  At the moment, I've had it on for 20 minutes and I'm ready to take it off!  It hurts just sitting here with my foot up!  Is progressing into an aircast the norm for this surgery?  Anyone else have this?

I was sent home with a prescription for custom orthotics as well.  I had orthotics for a short time as a kid (to help with my flat feet) and remember them hurting badly.  I'm hoping that the comfort level of orthotics has improved over the last 30 years or I'm sh*t out of luck!  In addition to improved comfort, I'm also hoping that they will fit in most shoes.  Wearing sneakers all the time is hurting my fashion style greatly :)  If you have orthotics, do you find them comfortable? Can they fit in most of your shoes or am I doomed to sneakers forever?

So, things are going well, and as planned, but I still have a few months left of rehab so I can gain my strength back.  The good thing is that I now don't have the other ankle holding me back.  I can go on the treadmill and not worry about my “bad ankle”.  No more bad ankles :)

11 Week Update -- Ankle #2

The cane is my friend these days when I go out...but when I'm inside, and have my boot on, I'm walking around the house without it...and there is little to no pain in my ankle while making my way around the house...probably because it's short distances.  However, my lower back or hip will start to ache before my ankles do.  My overall strength and balance is getting better and I'm able to move more quickly.  My foot doesn't swell as quickly and I haven't iced it, outside of therapy, for about a month.

I've tried to do more stuff around the house...wiping up counter tops, loading up the dishwasher, and overall tidying. With some modifications (like doing the prep work sitting down), I even managed to cook dinner the other night (read about my chicken soup without chicken post here).  Although I can do more, most of the housework and cooking is still being handled by my family.

This Friday I make my way into Washington DC to see my surgeon and get my boot off.  I'll keep everyone posted on how my 3 month check up goes!

Ankle #2 ROM -- 9 Weeks Post-Op

Pre-Op Measurements

If you remember, I had my therapist, Jenn, take measurements of ankle #2 before I had my total ankle replacement surgery.  When I took them, the thought was that I'd be all scientific-like with the comparisons. (For my post-op measurements for ankle #1, and comparison measurements for both ankles click here.)  Here are my PRE-OP numbers...all are active range of motion (meaning I could get to these numbers on my own):

Plantarflexion                40

Dorsiflexion                  10

Inversion                       30

Eversion                        10

Standing Calf Stretch     30

Post-Op Measurements

Here are my numbers from last week, specifically last Thursday...which was 9 weeks, 1 day POST-OP for ankle #2 ...these are passive range of motion (meaning Jenn can push my ankle to these measurements):

Plantarflexion                40

Dorsiflexion                  10

Inversion                      35

Eversion                       15

Looking at these numbers, it seems like I'm on the right track!  The passive ROM should be more than the active ROM...so my measurements for inversion and eversion being more now than pre-op aren't too surprising.  In another few weeks I see my surgeon and Jenn will do my measurements again.  I'll have to remember to take both active and passive ROM measurements.

Anyone else have ROM measurements they want to share?

Physical Therapy 0-16 Week Protocol

This is the sheet I came home with from the hospital that the doctor instructed me to give to my physical therapist so they can follow the proper protocol regarding rehabbing my new ankle replacement.

You can see that it's all wrinkly...this is the sheet that I was given from ankle #1.  My therapist, at the time, made a copy for herself and gave this back to me.  For ankle #1, it was hard to judge where I should be in the timeline since I was in a cast for 7 weeks.  This time around, it's a bit easier to judge.

I just hit my 8 week mark, so I'll be moving into the "Weeks 8-12" box of instructions.  I'm hoping to see some real improvement in the next 4 weeks!

Anyone else come home with a set of instructions?  Did you find it helpful?

Wouldn't it be nice if everyone came home with a set of instructions? :)

8 Week Update -- Ankle #2

Wow...has it been 8 weeks already?  It doesn't seem that long to me...but it does seem like forever since I've been doing normal stuff...probably because once I started feeling kinda normal after ankle #1 I was having surgery again.  What can I say...I'm a glutton for punishment.

Anyway...things are a bit slower this week.  If you read my post from Monday, you'll see why.  Not much has changed...or I should say improved.  Actually, I feel like I'm where I was about a week and a half ago.  I have physical therapy tomorrow and it will be interesting to see what she has me do.  I don't know if I'm ready to go back on the treadmill just yet...but at the same time I feel disappointed in myself if I don't even try.  I just don't want to move backwards again.  I need to keep improving...not doing all this backwards shit.

I'm really getting a little stir crazy...yeah, it only took 8 weeks!  The very best part about this week was that I was able to get out this past Saturday...even if I had to use my crutches.  I went to Walmart (with the use of the wheelchair) and went to lunch at Panera.  Oh how I loooove Panera.  These two outings were the most “normal” thing I've done since the surgery.  Yeah, my life is so exciting...don't all be jealous at once :)

I've decided to clean out all the prescriptions I was given after the surgery since they've been collecting dust on my bedside table for a couple of weeks now...this is a lot of medicine!  I can't tell you how happy I am to be off of these.  Now I'm just back on my Celebrex (for my arthritis) and Soma (for my back spasms).  At least my medicine routine is back to "normal".

Have you ever gone through something and couldn't wait to get back to "normal"?  What was it that finally made you feel "normal"?

The Evenup -- The Accessory To The Walking Boot

Have you ever hurt or fractured your foot or ankle?  Or had foot or ankle surgery?  Did you have to go into the dreaded boot for some time?  Did your hip, knee, or back start hurting when you were in the boot?   If this sounds like you, then you are going to kick yourself that you didn't know about this little beauty.   It's called the Evenup.  And guess what it does...that's right...it evens up your leg heights so you no longer have to worry about finding the perfect wedge shoe that will match the height of your boot.

When I got the cast of ankle #1, the lady who fitted me for my boot gave me information about the Evenup.  My first thought was, “Genius!”.  I went home and ordered one a couple weeks later.  I figured that I had some time since I couldn't really put weight on my foot and walk yet.  Well, I should have ordered it sooner because by the time I needed it, I needed it right now.  It did come rather quickly, but still I should have anticipated better.

By the time it came I was so relieved.  My hip and lower back had already started hurting...and I wasn't even all that mobile yet.  For those of you who have never worn a boot...understand that even the smallest difference in leg height will throw off your gait just enough that it will wreak all kinds of havoc on the rest of your body.  Seriously, such a small difference can cause a ton of pain.

The Evenup will fit around any shoe (I imagine) and has two layers of foam in it (so you can remove one if need be).  It gives me about another half an inch...just enough to be even with my boot.  I absolutely love it and the minute I got the okay to wear my boot with ankle #2 I started using the Evenup immediately.

So if you ever have to be in the boot, or have a friend or loved one who does, this little thing is a lifesaver.  It cost me $35 and I got it in about 5 days.  I ordered directly from the Evenup website, but sometimes Amazon has it for a little cheaper.  Spread the word!