Week Ten (Part 1): “Feeling Loopy- and it wasn’t the drugs…”
(10 weeks post break / 9 weeks post ORIF)
TODAY (Friday the 13th) was screw removal surgery day!! I was ecstatic! I took
my 4th shower in less than 24 hours…I simply couldn’t get enough of
the feeling of actual water running down my leg that had been freed from its
fiberglass cast (a cast that I had been trapped in for nearly 10 weeks)…
I got dressed in my ‘surgery casuals’ and we headed to the
hospital.
They took me to pre-op and I was adamant about wanting to
have the procedure done with local anesthesia. After my first surgery (and the
very uncomfortable experience with the intubation). I wanted to avoid being
intubated, and asked if I could be sedated and have local anesthesia (or a
nerve block) instead. After some convincing (and the anesthesiologists finally
realizing that I would only be getting one screw removed, not all the hardware-
as they previously assumed), they said that local anesthesia and sedation would
be sufficient. Obviously, if they felt the need to intubate me, they would make
the best decision for a seamless procedure during the surgery.
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| Pre-Surgery: As you can see, the meds have started to kick in... |
After that, my surgeon came in. The Wizard of Oz! And I didn’t
even need to beg 3 different people to get to see him! Haha!
He signed my surgical leg, and briefly stated what they would
be doing. I mentioned the local anesthesia, and he said that would be fine.
Again, he did not want to do a nerve block (it was his surgical preference).
Since this procedure would have minimal pain in comparison to the first one, I
was not too phased. I asked him when I could begin Range of Motion (ROM)
exercises/physical therapy, and he said that I would have to wait until the cast is removed.
“I thought I would be in a boot after the procedure?!” I
exclaimed. Panicked. Wishing I had taken a 5th and 6th
shower…
The Wizard said that he traditionally puts people in a hard
cast after surgical procedures. Including this one. He did not explain why. At
this point the drugs started to kick in, and I felt too relaxed to continue to
ask him why. He said I could still begin bearing weight- as tolerated. WHAT!?
This was the opposite of what the PA said to me yesterday.
PA: Surgery will be followed by the boot, I could begin ROM
on my own at home. And NWB until the post-op appointment. After which, I could
begin PT and then eventually begin weight-bearing.
Doc/Surgeon/Wizard: Surgery will be followed by hard cast. Weight
bearing as tolerated. As soon as I feel up to it.
I was feeling loopy. And it wasn’t the drugs…
I came out of surgery, groggy, and still very confused.
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| Apple Juice! The most delicious (and ONLY) thing I had consumed in hours and hours! |
Lucky for me, I had a very nice nurse. Even though she stabbed me quite a few times, in order to insert my IV- at least she got me apple juice and a warm blueberry muffin!
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| The nurse's signature: Signed in my own blood...ha! |
I spent the rest of the afternoon napping on the couch, and
trying to make sense of everything that had occurred.
 |
| Surgeon's Signature: Signed in my broken dreams... |
At-least I got another PINK cast…
Hello! I just started following your blog yesterday as I too have suffered a broken ankle and will require surgery. 4 days ago I was playing in a outdoor flag football game when I suffered a trimalleolar fracture and dislocation of my right ankle. It had rained somewhat a day before and so the field was wet but we played anyway. 2nd play of the game I caught a pass, tried to change directions, my left foot slipped and I sat down on my right foot as my ankle twisted under me. I too heard the snap, crackle, and pop. I tried lifting my leg and my foot was hanging from my ankle. Needless to say I knew it was broke immediately lol. Ambulance showed up and splinted my leg and placed me on the stretcher. Went to the hospital where I had my ankle popped back in. Had it x-rayed and was diagnosed with two breaks in my fibula, 1 in my tibia, and a dislocation. I had a soft cast put on. Was referred to a specialist two days later who confirmed the injury and scheduled surgery for this week. Had another cast out on and now I'm home on the couch with my foot up. I've been watching videos about the surgery, reading blogs, and just waiting for surgery. I've been an athlete all my life and have unfortunately had injuries before so this is my 4th surgery. I had an ACL on each knee. A left ankle ligament reconstruction from repeated sprains. This however was my 1st break and according to my surgeon I did a great job lol. I've enjoyed reading your blog and seeing how you have managed to keep a good attitude about your injury. I'm hoping I can treat my recovery the same way. Take care of your ankle and I hope to read more from you.
ReplyDeleteHi Dion!
DeleteThanks for your very kind words! It really sounds like you have been through quite a lot! Your break sounds very painful, but you sound very tough- and I know that you will get through this! How was the surgery? I hope that everything went well, and that you are well on your way to recovery now! It sounds like you already have a great attitude about your injury- so I have no doubt that you will be able to kick this injury's butt!
If you ever have any questions, feel free to ask! I would be very happy to help!
(One of my biggest concerns after the break was the fact that I needed to rely more on my 'bad' leg (AKA the one with the most recent ACL surgery- even though it was 4 years ago)! Luckily, I think that this experience is really going to force me to trust it again! Haha!
Meanwhile, I now have to overcome my newly developed fear of all things slippery...!
Hang in there! :)
Hey thanks for the reply. I had a successful surgery on trimalleolar fracture and dislocation over a week ago. 1 plate and 11 screws were inserted into my leg to fix the breaks. Ankle and foot were successfully realigned and the ligament damage was treated as well. I had a nerve block put in which wore off 2 days later. That was painful! Pain right now is between a 6-9 especially when I have to get up. I go back in a week to have the splint taken off and a cast applied. Looking at 8-12 weeks non weight bearing.
ReplyDeleteHow did you manage the pain post surgery? I've had surgeries in the past but this is the most pain I've ever felt post surgery. How did you feel post ORIF? Thanks again for replying to my post and hope your ankle is healing well.
Hi Dion,
DeleteI am glad to hear that your surgery went well! You are lucky that they gave you a nerve block, unfortunately- my surgeon doesn't like to do them- so I was in a lot of pain as soon as I woke up after surgery. They didn't even manage my pain before releasing me from the hospital. I also agree with the post ORIF pain being worse than any other surgical pain that I have experienced. Both of my ACL reconstructions were nowhere near as bad as this surgery was. I would say that my post ACL pain was around 6-8 after surgery, and was easily reduced to a 4-5 with pain medication. For the ORIF the pain was a 9-10 after surgery, and the pain medication truly did not move it below an 8-9. I did not get ANY sleep at all in the first 3 days after surgery. I was exhausted, but it was way too painful to sleep, I think that part of the reason an ORIF is so painful is because of the trauma to the bones during surgery. There is a lot of manipulation and drilling into the surface of an already injured joint, and the amount of hardware that goes in is fairly extensive compared to an ACL reconstruction or meniscus repair. The bone pain (the very deep aching and throbbing that seemed to resonate throughout my body) in combination with the burning pain from the very sizable incision(s) is likely why it is a fairly awful pain.
For pain management after surgery, I did a variety of the following:
- I elevated my ankle 23 hours a day. I basically lived on my couch for that first week, only getting up to pee.
- I put an ice pack behind the knee of my post-op leg, which would cool the blood as it went towards the injured joint, providing some relief. (I had a hard cast immediately after surgery- so icing the joint itself was not possible for me).
- I religiously took the pain medication, and added NSAIDs on top, in a constant schedule. I set alarms on my phone and would take Hydrcodone + Tylenol every 4 hours, with Ibuprofen staggered in between. I did this for the first entire week, until the pain became less inhibiting.
Unfortunately, I was not able to get much pain relief until day 3, and did not feel a significant reduction of pain until day 7-8. The reduction in swelling also helped reduce the pain.
I hope you have some better luck with pain relief, and are on your way to healing!
Hey thanks for the reply! I just had a cast put on 2 days at my 2 week post op check up. Got to see my incisions and found out saw my X ray. Skin,swelling,and the incision looked good according to the doctor so I'm right on schedule. I'll be in this cast for 4 weeks then will have another surgery to have the syndesmotic screw removed. Pain level is at about 5-7 right now with tightness at the back of my ankle and a dull ache at the front of it. I'm still taking Tylenol to treat the pain.
DeleteI agree with your theory of why ankle orif is so painful. It's actually the same thing my doctor said. With so much trauma associated in injuries like ours the recovery is often quite painful. My doctor said my pain level was actually normal based on having 3 breaks and a dislocation. My 1st ACL surgery was pretty painful in recovery as well but I tore 3 ligaments (acl,mcl,pcl) and my meniscus.
Hope your ankle is healing well. I think you'll agree that breaking an ankle is not easy lol. Take care of your ankle and continue to make progress with it.