Broken ankles hurt

I'm glad that, when I saw the orthopedist, he said that the first 10-14 days were typically the hardest with this kind of ankle injury. I need a first end-of-the-tunnel date.

There was one day in there, maybe Thursday, when I took almost nothing for pain and was fine. That isn't happening now. I keep a card in my backpack to track my acetaminophen intake so I don't fry my liver as I try to stay ahead of the pain. For the last two nights, I've awakened in the early morning in pain and needed to take something and then wait for it to kick in before I could get back to sleep. I think it's time to start setting an alarm and taking something before I hit that point. This brings back memories of C-section recovery, and not the fond ones about the adorable new baby. It was the same story then: If I stayed ahead of the pain, it didn't take much to keep it within my tolerance. If I didn't, it took more medicine and/or stronger medicine to get back in the lead.

I managed to finish my kids' Halloween costume items last night. Fortunately I'd gotten most of the work done before the injury. We have a forest protector (brown clothes, green cloak I made for another year, and ack, we didn't find her new boots since she outgrew her old ones, so maybe snow boots...) and a skeleton ranger (skeleton jacket and pants, midnight blue cloak I finished last night).

Fast forward three days. I've finally gotten ahead of the pain, but it's taken going on mild narcotics around the clock. I checked in with an orthopedics nurse, and she says this is not unusual in the second week with a broken ankle, and that in 5-6 more days (this is day 8 since the injury) I can probably start weaning off them for at least parts of the day.

Halloween was refreshingly simple. The kids went around the block on one side of the street and didn't even bother with the second side. I guess they get enough access to sweets that getting as many as possible for Halloween doesn't feel too important. They are enjoying eating the leftover bags of Cheetos that we bought to distribute.

On another note, I love my choir. They're working on a pretty hard piece for me, and it's really coming together. I heard some very beautiful things at rehearsal tonight, which is good, since we're singing that pieces in services this coming Sunday. Our music director, who also works with a women's choir at CU, said that choir (about half music majors and half not) would have taken most of a semester to prepare a piece like this. We've taken 4 weeks. It helped a lot that he gave up most of the regular choir rehearsal tonight so the women's choir could work on this piece.

A diagnosis, prognosis, and course of treatment

I saw the orthopedist this morning. Tim dropped me at the bus stop, and I rode the bus and walked about a block to Kaiser. That was really hard on crutches, with already-sore shoulders and wrists and putting weight on only one leg. Tim picked me up afterward so I didn't have to do the reverse trip. The knee scooter, which came this afternoon, should make future bus trips more manageable.

They didn't re-x-ray my foot, as they could see what was wrong from Sunday's x-rays. A ligament attaching the lateral ankle bone to the bottom of my foot tore out its lower attachment point. The doctor thinks it will scar back together on its own if I protect it with the boot for four weeks, so that's the plan. We'll x-ray again in four weeks to see if it worked, and if so, I can switch to a lighter splint, worn with a sneaker, which may allow me to drive. He wants to avoid foot surgery if possible, since the risk of complications (mainly infection) is very high.

In the meantime:

• No driving (it's illegal with a boot on my right foot).
• No ibuprofen (NSAIDs interfere with the inflammatory response and thus with parts of healing).
• Tylenol and pain pills are okay, but not at the same time to avoid acetaminophen overdose (I'm allowed up to 3800 mg per day).
• I should bear some weight on the foot for parts of every day -- starting with just a little, and gauging my tolerance by whether I'm in significantly more pain the next day. The knee scooter is okay, but I shouldn't rely on it too much, especially if it keeps me from bearing weight regularly.
• I can ice periodically, especially for the first 7-10 days. After that, it doesn't affect things as much, but it might help with pain.
• I should keep the foot elevated as much as possible, to minimize swelling.
• I should stay out of hot water -- baths, hot tubs, etc. -- and shower with water just warm enough, not too hot.

I forgot to ask if I should be doing any rehab exercises yet, so I emailed that question and hope to hear back. I also asked if the doc could tell me the names of the ligament that tore the bone, and the bone that got torn. This feels important to know, for reasons that are hard to explain. I guess the more I know about the injury, the more information about it is available to me about it, and that may help somewhere along the way with rehab, or even future injuries or choices of things like footwear. But besides those practical considerations, I'm pretty fascinated with biomechanics and anatomy, and I'm a lifelong learner. This is the sort of curiosity and learning that frequently leads doctors to ask me, the first time they meet with me, if I work in health care myself. The same thing happens with other professionals, like the state geologist who helped me figure out if our new house was on top of a coal mine in danger of collapsing (yes, it's on top of a mine, but one that appears already to have collapsed fully). That geology conversation was very enjoyable for both of us! I took a two-semester class in geology in college, and coal mine subsidence/collapse was one of the instructor's pet issues, so we learned a lot about it.

A month of no driving is new for me. We got two rides today, to get us to a class for one of the kids and back. We can get there on a bus in future if we're up for it. At times like this I feel very grateful to live near four bus lines. They go most places I need to go regularly, except my church, but there are many people willing to help with rides to and from church, since we live so close to it. Being involved with groups there, like choirs and small group ministries, really rocks at times like this, because there are lots of people who know me pretty well, have compatible schedules, and are willing to help. But I've had help from more casual acquaintances, too, called in by the Neighborhood Connectors program, which hooks people who need help up with neighbors who can give it. I used to be a neighborhood connector myself, so I've been on both ends of this.

Time to get the kiddos to bed and get on with my first post-injury shower, now that I know how to do it safely and am properly equipped!

Broken ankle -- a new adventure, I guess!

This past Sunday the kids and I, as well as some extended family, went to play badminton with my husband Tim, who is a regular at a badminton club that includes everyone from novices up to the state-champion/Olympic-hopeful category. He's a competitive player, with a B ranking.

We were having a great time. I was playing better than I have before (I'm not much good, but this was better than past tries by a fair distance). Tim was dialing it back some so he and I could play doubles against people with not-quite-so-intense-as-his badminton skills and have a good time. We had come from behind to a small lead when I dove for a shot to my right... and rolled my ankle, hard. It made a series of ominous popping sounds. I was down, and we had to call the game. But hey, I made the shot! Tim didn't notice I was down until he went to return the return of my shot. The man keeps his eye on the birdie!

It hurt a lot in the first half hour. Folks helped me to the sidelines and brought ice, and Tim stuck with me. I cried for a little while from a mixture of pain, overwhelm at getting so much help, and fear about the way my foot was moving when I tried to hold it still -- like one of my usual control wires (ligament or tendon) was disconnected or something. Then the rec center lifeguards took a look, but they didn't have much to offer for first aid. After half hour the pain was getting worse, not better, so my wonderful sister-in-law Melissa took me to Kaiser urgent care to get it checked out, while Tim got the kids to their afternoon Navigators (coed inclusize scouting) meeting, which I was supposed to be helping lead. :(

Broken, they said. But there was so much swelling that they couldn't tell what the nature of the break was, exactly. They gave me a Cam boot to immobilize and protect the ankle, and a referral to orthopedics. They also gave me some painkillers in case ibuprofen wasn't enough, and instructions to stay on ibuprofen around the clock for now. By this time I had some in my system, and the pain was at a much lower level.

Melissa brought me home and set me up with water, food, a book... we couldn't find the crutches I knew were in the house somewhere, but I could crawl or butt-scoot if I needed to get around.

Just after Melissa left, Tim got home and found the crutches, increasing my mobility by a factor of 3 or so. I still couldn't carry, well, almost anything, so I was very dependent on people carrying stuff for me.

That night, I kept waking up with uninjured parts of my foot in a lot of pain. The boot was pressing on them in weird ways, and I couldn't find a way to fix it. I took a painkiller and fell asleep, only to wake up a couple of hours later to intense nausea, sweating, and weakness. Bad reaction, but it subsided fairly quickly, and I got back to sleep and slept in for hours past my usual wake-up time.

Monday I took things easy, mostly. I walked two blocks to the library to return some books and found it really rough going on crutches. The library is about the same distance away as the bus stop; bad news for my mobility with a broken right ankle. So I got signed up for paratransit and ordered a knee scooter (to arrive Wednesday), which should be a lot easier to use than crutches. I got an appointment for Wednesday morning at orthopedics -- I didn't like to wait so long, but I understand, since it will probably take 3 days for the swelling to go down enough to make a good diagnosis. I also figured out how to readjust the boot so it doesn't cause me pain, just annoying discomfort, a small price to pay for protecting my foot. I got a ride to the choir I direct and the one I sing in (back to back rehearsals in the same place). I almost didn't go, as I was pretty exhausted from my rough Sunday night, but I thought about how I usually end up more refreshed after choir than before it starts and decided to give it a go. I'm glad I did. It was good to see more friends and make some really beautiful music together, and I did feel refreshed and heartened.

Monday night was much better. Having talked to a doctor, I loosened the boot a bit with his blessing, so my foot was still protected but not quite as constricted. Mostly I slept pretty well, and I didn't take, or need, a painkiller beyond ibuprofen.

Today is Tuesday. The support network at my church has kicked in, and a friend delivered a walker with a detachable tray so I can carry things (Monday I ate my dinner right in front of the microwave because I couldn't carry it to the table!), and a shower stool. I'm still mostly taking it easy, just trying not to injure the foot worse. I'm working on logistics, planning bus trips or rides to the places we can't easily cancel or reschedule. We already have several rides lined up to classes and church/choir events.

I hope tomorrow's appointment brings some answers about what's going on and what we can do about it. Tim and I spent some time one night going over possible scenarios that might arise with the ortho visit. I'll probably be there by myself, and I wanted to have some mental immunization to possible outcomes so nothing could throw me for too much of a loop. Tim is a terrific imaginer of worst-case scenarios and had some doozies for me (bone density problems or cancer), but the more-likely scenarios he came up with were things I felt I could deal with. We shall see.