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

Six Word Saturday -- April 12

It's Six Word Saturday time...

I have muscles in my butt!

After months of rehabbing my ankles, I have muscles that I haven't seen in years.  Thank you physical therapy for bringing them back to life :)

Six Word Saturday is hosted by Call Me Kate at Show My Face.  If you'd like to join in on the fun, then describe your life (or something) in a phrase using just six words and comment down below!

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.

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?

9 Week Update -- Ankle #2

My ankle has finally started feeling better since I overdid it in physical therapy a couple of weeks ago.  It doesn't hurt anymore to just stand on it, and when I walk, the inside of my ankle doesn't hurt anymore.  This is about where I was in the beginning of the week of January 20^th.  The end of that week is when I had to go back on crutches because of the pain.  (To read about how I overdid it and ended up in pain, click here).

So I'm back to walking around using just my cane, which I'm mostly using for balance.  When I walk around in the boot, there is little to no pain.  When I don't have my boot on, there is some pain when I walk, but nothing horrific.  I have pt tomorrow and I'm hoping to get back on the treadmill...I'm done babying it and want to get back on track.

The biggest problem the past few days has been the pain in my left hand/wrist.  This was bothering me a lot right after surgery...mostly because I was non-weight bearing and had to carry most of my weight on my hands when getting around with my walker or crutches.  It had eased up after I started putting weight back on my foot.  Maybe it's because of the weather (the snow and the ice storms), or because I was back on my crutches for a week, that it has hurt more. I'm hoping that it eases up in the next few days.  If not, I'll have my acupuncturist work on it some this weekend.

The best parts of this week...

1. I had a cleaning service come in and do a deep cleaning of my bathrooms.  It cost me a small fortune, but I'm so much happier now that I can see through my glass shower doors again.
2. I went to dinner last Friday night with my hubby and kids.  Walked into the restaurant with my cane and was able to sit through dinner without my foot swelling like crazy.  Little by little, I am improving!

My super clean shower!

 

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? :)

One Step Forward...Two Weeks Back

The beginning of last week was awesome.  I was able to put a lot more weight on my ankle and my balancing had started to improve.  Because of these two things, getting around was easier, to the point where I had started using my cane.  I was really improving and was starting to feel more “normal”.

And then Thursday happened.

I had physical therapy on Thursday and did all of my regular exercises...nothing new.  And I ended up hobbling out of the PT office.  That entire afternoon was pretty sucky.  Even if I was just sitting with my foot up, it would just throb.  I tried taking ibuprofin when I got home and then later that night, and it did nothing to help the pain.  Ice didn't help either.  The only thing that helped was if I stayed off of it completely.  So I did.

Both Friday and Saturday weren't much better, although the throbbing was limited to only after I would try to walk on it...so that was a mild improvement.  I went back to using my crutches and tried to put as little weight on it as I could for a few days.  My ankle felt as if I had gone back two weeks.  And the bone that I had the screw put into was what was hurting.  It was tender to the touch.

I had acupuncture Saturday morning and by Sunday it felt a little bit better (usually acupuncture takes a day to “kick in” for me).  Today, Monday, it feels about the same as yesterday, maybe a slight bit better.   It's still tender to the touch...as much as a few days ago.

After explaining everything to my therapist, she said that it could have been how aggressive she was with the distraction last Thursday.  The weird thing is that when she did that, it didn't hurt.  Only afterward, when I tried to walk on it, did I feel pain.  She didn't do much hands on today...gonna give it a rest...and next session she will just go a little easier when distracting.  I'm hoping by my next PT appointment that I will be able to fully walk on my ankle again and can get back to the treadmill.

It's funny how you have to sometimes push your body past it's limits just so you know where your limits are.  The 'ole “I really shouldn't have done that” routine :)  How many of you out there have done something similar?  

6 Week Update -- Ankle #2

One of my newest exercises this week is to stand on both feet (with my boot on) and try to rock up onto my toes and then come back to neutral.  This may sound easy, but this is essentially a calf raise, and I haven't been able to do this on my ankles for years.  As I mentioned before in another post, the last time I tried these exercises I hurt my ankle so bad that I couldn't walk on it for weeks.  Now when I try this exercise, I feel pain in my right ankle (#2), and I feel muscle strain in my left (ankle #1).  I'll probably start feeling muscle strain in my right once I start doing this with the boot off.  I think I start PT exercises with the boot off in another week or so, even though I will still have to wear it normally until end of February.

I can stand 50/50 easily now and can even “one-crutch” it around the house if I'm in the boot (but not for long).  Hopefully, I'll be able to adjust to the cane in a couple of weeks.  Without the boot, I still need the support of both crutches or the walker.  I use the walker upstairs and the crutches downstairs and when I have to go out.

This is going to sound like a weird thing to be happy about, but I can now cross my feet at the ankles...just figured that one out a couple of days ago.  Basically, this means that my incision isn't that sensitive anymore.  I meant to take a pic of my incision today, but I forgot...I'll try to remember and add it to my photos page by the end of the week.

Something about my incision that I haven't mentioned before...I definitely have some nerve damage to part of my foot....from the joint on my big toe to rest of that side of the top of my foot...make sense?  Yeah, I probably should figure how to do some photo-shopping or something for a visual aid.  By the by...I didn't have this with ankle #1.  Anyone else whose had this surgery...do you have any nerve damage?  I'm wondering how prevalent it is.  I hadn't mentioned it before because I was waiting to see if the numbness would go away.  I figure that since I'm at the six week mark, it's probably here to stay.

My big trick of the day... I stood today to wash my hands.  Again, this seems like a minor thing, but I didn't really have the strength or balance to do this just a week ago.  My bathroom in my room has the soaking tub right next to the sink, so I have a place to sit while I wash my hands.  And, if I'm on my main floor, that bathroom is so small that you can put the lid down on the toilet and sit and use the sink...it's a seriously tiny bathroom!  So, for the past 6 weeks, I haven't had to stand...but today I did...and it was magical :-)

Picture by Yinan Chen - www.goodfreephotos.com

29 Day Update -- Ankle #2

Today in physical therapy we started weight shifting...oh happy day!  Weight shifting is exactly what it sounds like...you stand up and shift your weight from your good foot to your bad one.  It's pretty painful, especially when you first start.  Right now, I can put maybe 25-30% weight on my operated foot.  The ultimate goal is to be able to stand on my new ankle and balance for at least 20 seconds.

I was also sent home with a green theraband today.  A theraband is a resistance band that is very common in physical therapy.  The different colors indicate the resistance levels.  Even though the green is not too hard, it's still a challenge for me right now.  Doing the theraband exercises is really helpful for recovery and getting your strength back.

Coming home from therapy was tough today...my ankle was really sore.  Luckily it was time for pain meds!  I took one Vicodin and iced it again.  Right now, just a couple hours later, it's back down to a 1-2 pain level.  Not too bad!

There is a bit of redness on my incision that I will keep an eye on.  It looks like I have a bit of a blood blister on it, which may be normal, but I'll need to make sure it's nothing more than that.  I'll monitor it over the next few days and make sure the area of redness doesn't get larger and that I don't get any other symptoms of infection (fever, pain and swelling at the site, etc).

It just started snowing a little while ago and I'm really glad that it waited until after my therapy was over to start...the thought of going out in my crutches and sloshing through slippery snow is scary.

The view from my window is so pretty...I want to go out and catch snowflakes on my tongue!

Last Day of PT...for now

Well, today was my last day at physical therapy before I have ankle #2 done.  I was going to make another appointment this week, but the only day that is available is Wednesday, and I have acupuncture that day...and doing both in the same day isn't an option.

I had my therapist, Jenn, take measurements of both ankles.  I thought I'd be all scientific-like with the comparisons since my right ankle measurements are really my baseline for my left.  Here are my numbers...all are active range of motion:

Plantarflexion                L=40 R=40

Dorsiflexion                   L=7 R=10

Inversion                       L=30 R=30

Eversion                        L=5 R=10

Standing Calf Stretch    L=15 R=30

Remember: my Left is my new ankle, or ankle #1.  The Right is still my old ankle, or ankle #2.

The inversion on ankle #1 is still weak, but I can get it to what my other one is.  Jenn says my numbers are reasonable, but would like to see me keep stretching my calf.  She wants me to do it every hour!  Oy...

Psoas Muscle.  From Wikipedia.

I can do 9 minutes on the treadmill, at 1.8 mph. It doesn't seem like a lot, and it's probably not, but I can't overdue ankle #2.  After about the 7 minute mark, my left hip starts to hurt a bit.  Jenn says that it's probably caused by my gait and did some hands-on stretching of the psoas muscle...which was lovely...it feels like she's pushing on your gut/groin.  Good times.

Also included in my PT routine: the thigh machine – 45 lbs, the knee machine – 15 lbs (just started this 2 weeks ago), the pilates reformer, the total gym (level 5), and table exercises (leg lifts, table top marching, etc).

At home exercises: gray theraband, core work (table top, pelvic tilts), stretching, leg lifts (straight up and side).  Also, I'll sit with my knees at 90 degrees, and put as much weight on my left knee as I can...and then do calf lifts with my left foot.  This is a cheat, because I can't do standing calf lifts yet...mostly because if I try to do them one legged (on the new ankle), I can't do it.  And I can't do it with both feet because my old ankle #2 is still shitty and will crumble to bits.  I know this because the last time I did calf lifts I couldn't walk on that ankle for a good six weeks.  Ankle #2--it's time for you to hit the road Jack!

I know everyone is different, but I always wonder where other people are at this point in their recovery. Is everyone else running marathons at this point? Or are you struggling like me?