The Value of Habit

It's been almost nine months since I broke my ankle. Surgery, recovery, and physical therapy have been good to me. I'm walking again and I'm starting to get back to a normal life. I still have some issues squatting on my heels and I still have daily, regular pain with each step. But it's getting better. I can walk, I can hike, I can almost dance.

I started thinking about this when my nephew Keith asked me whether I would ever be able to run again. He's ten and those kinds of things are very important to an active kid like he is. I said that I couldn't at the time, but that I was hoping to soon. And it's true. I would really like to be able to run again. I would like to be able to jump and dance and my real hope is that eventually I won't even have to think about my ankle. But I'm not there yet.

I'm still struggling to recover. My motion is not quite right and there is still a lot of internal scarring. I fell off doing my physical therapy exercises shortly after I stopped seeing my therapist. This week I've just realized how damaging that was. I've lost a lot of good recovery time thinking that walking was all I needed. Now I realize that if I had let the physical therapy exercises become a habit, I would be running by now. I would be dancing. I don't know if I'd be back at 100% but I'd be closer.

Last night I stood in front of the TV doing some of my exercises. It felt good to be stretching and strengthening those muscles. I worked on my calves and on my range of motion. And I'm feeling better today. I feel stronger, even with a bit of discomfort. So tonight I'm going to set aside some time to do all the exercises. Even a half-hour out of my day will hopefully let me improve. I was strong during physical therapy. I want to get back to that again.

Going It Alone

Or What a long strange trip it's been.

When I broke my ankle back in January I knew that this day would come but I didn't realize how odd it would feel. Tomorrow is my last scheduled day for physical therapy. On Sunday I get to remove the brace and start walking like a normal human being. In some ways this is the end of my treatment. Two attempts to set the bones, a surgery with screws and plates, two weeks of no weight bearing, one and a half months of limited weight bearing, and two months of physical therapy with full walking have all come down to this.

After tomorrow there will be no one to push me through my physical therapy. There will be no one there to guide me through the recovery process. After tomorrow I'm on my own. I'm both scared and thrilled at this. No matter how much I love my physical therapist, I won't miss taking off work last minute to attend appointments. As much as I appreciate the doctor who did the surgery, I'm glad he feels confident enough that he doesn't need to see me again. And no matter how much I've needed the directed recovery in the past, I'm ready to step out (pun intended) on my own.

I can walk now, mostly gimp-free. I can climb steps, although I still need the handrail. I can stand for long periods of time without pain. The only things I can't do right now is hop, run, and crouch. And I'll start working on those. I've learned the value of physical therapy. Of working daily to make myself stronger. I finally understand the old adage: if you don't use it, you lose it. That is very true for muscles. As I rebuild my calf muscles, my achilles tendon, and my knees I'm reminded that you are either getting stronger or atrophying. For the last couple years I've been letting myself go. I'm been letting the muscles grow soft while I sit on the couch. I've been ignoring my body. But this injury is just what I needed to give me an added push.

When I was sitting on the couch right after the break, I dreamed about walking. When I was slowly starting to walk with the crutches, I dreamed about getting rid of them. When I finally put down the crutches, I dreamed about walking without a limp. Now that I'm walking without a limp, I dream about running. I dream about running for distance. I want to strengthen enough to run a marathon. It's been a dream of mine for the last ten years.

So my next step will be to start walking for distance. As my muscles and my endurance build up I can start learning how to hop. And once I learn to hop I can start teaching myself to run. I know that I always have back-up from my physical therapist if I need it. I can always go back. But for right now I have a goal, I have ambition, and I have the energy to go it alone.

Bracingly Good News

I meant to write yesterday. I had time to write in the morning but wanted to wait until after my doctor's appointment to do one last post about my recovery. After my appointment I had errands to run, new shoes to buy, and some friends I was meeting for dinner and drinks. I didn't get home until late and after the beer I had with dinner I wasn't feeling very writerly. So no post. And in some ways I'm glad I waited until this morning. I wanted to talk about my appointment but wasn't really sure how to explain the excitement and disappointment it had elicited.

I'm not sure what I was expecting. I hoped to get my boot off. I hoped to see some good healing. I got some of my wishes. I'm mostly healed, mostly. There is still a big gap in the ankle bone that the doctor has decided is either probably not going to heal or will take a good year to heal. But he's not worried about it either. No further corrections needed on that. I also still have a dagger like bone fragment that will probably always be a bit ajar in the back of my foot. But no worries on that either. So I'm healing and stable.

I got rid of the boot only to trade it in for a brace which I'll wear for another month. I'm not to take a step on the foot without the brace and a shoe on. I can sleep with it off but the rest of my walking time I must have it on. I'm not sure how I feel about this. The brace is painful in ways that the boot never was. It's an added element that complicates dressing in the morning or late night bathroom visits. But it also allows me to wear real shoes again. And more importantly it allows me to walk like a human again. I can now walk with a bend to my ankle. I can go up and down steps like a normal person. I'm finally able to really start rehabilitating that ankle.

The big news for me though was that in a month I can get rid of the brace and be fully healed. I can start returning to all of my old activities. I can hopefully stop thinking about my ankle, stop worrying about it. And more importantly I don't have to go back to the doctor. No three month follow-ups. No yearly visits. Done! That may be the best sign I could ask for that I'm healing. I've been released by the doctor. I'll still do Physical Therapy for the next month (only because I begged) but no more x-rays. No more waiting rooms. Done! Three months has never gone so slow and so fast at the same time. Now just one more month to go.

These Boots Are Made for Walking

That's why they call it a walking boot.

This post is a tribute and hopefully a send-off to my long hated, long loved walking boot. I go see the doctor on Monday and pretty much everyone agrees that I will probably be told that I don't need it any longer. It's been 13 weeks since surgery which doesn't seem like a lot until I say three months. I've been wearing this boot since January 4th and although it's been incredibly helpful, durable, and sometimes comfortable I'm ready to say goodbye.

I was casted in the emergency room with a removable plaster cast. It was heavy and frustrating. But I didn't really hate it. I didn't have it on long enough to hate it. When I woke up from surgery it had been removed. Instead I was staring at a gigantic black walking boot. The same one you see below. It was heavier than the plaster. It was more cumbersome and for the first two weeks, served no real purpose other than that it was removable.

When I first started wearing it I couldn't even remove the damn thing by myself. I couldn't bend enough to pull off the far straps. At least I couldn't without putting some weight on my foot which was strictly taboo at the time. After a while pulling the boot on and off got easier. But it wasn't comfortable. With my leg wrapped in gauze and Ace bandages it was constantly rubbing. Once the bandages were gone it became comfortable. And about that time I could actually start putting some weight on the leg. After two weeks I was using the boot the way it was meant to be used, with weight bearing. But I still hated it. I chafed my foot and leg. It smelled after only a couple days of wear. I could only wash it occasionally and that was almost always more a nuisance than it was worth. Sleeping with it was frustrating (and still is) and I still wasn't able to really walk. I was still crutch-bound, just with a huge leg weight.

It wasn't until 8 weeks that I really started to appreciate it. Once I started physical therapy and slowly did away with the crutches, I realized the value of this gigantic fake appendage. It protected. It soothed. It walked. I've been walking for a couple weeks now without the crutches. I've become comfortable walking. Other than the occasional really high curb I can pretty much go anywhere without a thought. I can carry things without worry. I'm back using my purse rather than the backpack. I'm feeling mostly human again. And now I an even better chance of feeling normal. I'll finally be able to wear matching shoes. Here's hoping that will be Monday.

Crutchless

Wow, one letter off and this might have been a very different post. A reminder to always check your spelling. :-)

I am officially crutchless. As most of you know I've been slowly weaning myself off the crutches for the last two weeks. It was slower than I expected but then again I never was good at just diving into something. I had gone from two crutches to one sometime last week and that felt good. Jeff and I were even able to go out and do some window shopping on Friday without too much trouble. And although I moved to the single crutch I noticed that I was starting to pick that crutch up when I walked. I realized how little I needed it. So last night I stuck my crutches into a corner and went to dinner without them. This morning I surprised my physical therapist by appearing in her office without them. I've been walking all over the house today without them and even managed to get out to lunch without them.

The thing that amazes me about this transition is how comfortable and natural it feels (nothing else in this entire process has seemed natural). It struck me as I stood outside our house talking with one of my neighbors. I hadn't seen this neighbor since December so she had no idea that I'd even broken anything. We were standing in front of the house catching up and I realized just how comfortable I was without having anything to hold me up. I stood with my feet at equal weight and I was perfectly balanced. I didn't even have any pain. It felt amazingly good.

For the first time in months, I can carry things. I put all my stuff back into my purse last night and no longer have to carry the backpack. I can even get into the car like a normal person now. I was originally terrified of getting rid of the crutches. Now I find it exhilarating. I never realized how normal I would feel so quickly. The physical therapy has really made the difference for me. I'm well on my way to recovery.

Hypersensitive

One of the things that amazed Jeff after he broke his foot was how incredible everything felt after he got his foot out of the boot. He told me that the first time he was able to touch his foot to the carpet, every sensation was heightened. The carpet just felt bizarre. He said that the sensations lasted for a while as he relearned to walk. Occasionally he would have to stop just to rub his foot on the floor to feel how odd it felt.

I'd been having similar feelings. Since I'm able to take my foot out of the boot earlier I noticed how the bottom of my foot was much more sensitive. The carpet had a roughness and texture that I simply didn't notice with my other foot. The throw blanket we have on our couch was almost painfully soft. The first time I draped it over my bare foot, I gasped. It was wild.

I mentioned this to my physical therapist and her eyes got wide. She asked me to describe the sensations. I said that things just "felt more...just more" (I'm so eloquent sometimes). She immediately followed up that she was glad I had mentioned it. Apparently when limbs, particularly feet, are unused for too long the nerves become hypersensitive. At the early stage this is not a terrible thing. Sensations are heightened and the person tends to find this interesting rather than scary. But if hypersensitivity is left unchecked, the sensations quickly become painful. Suddenly just touching a fabric to the foot would be like stabbing it with pins. Too much sensitivity is apparently not a good thing.

So part of my physical therapy is to rub my foot on any texture that feels heightened. I've been rubbing the bottom of my foot along the carpet, the walls, the linoleum, blankets,... pretty much anything. I recently noticed that our bath mats felt amazing so I spent ten minute rubbing my foot along them. I'm sure it's starting to make Jeff a bit concerned about me. It's a bit odd to be working to make myself less sensitive. But I have noticed that since I've started walking more, these sensations are growing. Nerves are an amazing thing. Hopefully mine decide to function properly again. At least once I get my boot off.

All Recovery...All the Time

It's the recovery channel, all recovery stories, all the time!! Sorry I know I just posted about my leg but sadly it's what on my mind recently. And as much as I would like to deny it, a broken ankle (particularly my type of break), is a big deal. I had an interesting discussion with my physical therapist this morning who told me that although she's hoping for a complete 100% range of motion recovery, it often tends to be more like 80 to 90% for trimalleolars. The plates and screws make a huge difference.

All that said, I've had an exceptionally good day recovery wise. The physical therapy is slightly painful and my foot is sore by the end of the day but I can finally see some good movement in the joint. It's faint and no where near where the other one is but I'm able to move it back and forth and side to side. It's day two of physical therapy and I already feel much stronger. I can move the foot more and am now able to put all my weight on it comfortably.

My big news for the day is that I have been walking for most of the day with just one crutch. I had been nervous to get rid of the crutches completely although I know it's the next logical step. So this was a compromise between my daring self that says go for it and the frightened side of myself that said don't rush. So far it has been working beautifully. I limp a lot but that's to be expected. And I can even carry things now. It's the little things. :-)

Mostly I'm just excited about the physical therapy. My therapist is wonderful, always careful and gentle with me, but still giving the ankle a good workout. I'm shocked at how little movement makes it tender. One of my exercises is to use my ankle to draw the alphabet in the air. I started with my good foot to try it and had no issues. But even the shift to make the A on my bad ankle is stretching muscles and tendons I didn't realize I had. It's slow going but it gives me something to work on and the feeling that I'm in charge of my recovery. And that is the greatest feeling of all.

Using my crutches as...well...a crutch

I just got back from the doctor about a half an hour ago or so. I was pretty excited about this visit. I assumed I would either be getting rid of the boot or the crutches today. And that's somewhat true but there's a bit of a snag, Me.

Things seem to be healing well. The bones are starting to knit although there is still a pretty big gap on one side of my ankle. Everything is aligned and the doctor sounds very optimistic. I've been able to put up to half my weight on my ankle up until now. He told me today that as long as I don't have any new pain, I can start weaning myself off the crutches. You would think that this would be the greatest news I've heard in a while. For a moment I was really excited. Then the fear set in. I'm terrified to get rid of them. I'm just not ready to go without them.

I know I've been complaining for weeks about the crutches. I've stumbled over them, I've cursed them, I've found them a nuisance. But now that I can set them aside, I'm clinging to them like a life jacket. They've become my safety. I'm using them as a crutch, quite literally. I assume that this is just first day jitters. By tomorrow I'll be looking for ways to get rid of them. But for today the idea is not only not appealing, it's terrifying.

On other recovery news I start physical therapy tomorrow. I'm a bit nervous about that but I'm hoping that it will help with the stiffness and help me recover faster. So in total I'm doing well. I just need to get over my fears. I've been dealing with new ways of walking for weeks now. I have to remind myself that this is just another step (pun intended :-) ).

Eight Weeks or a Rambling Post about Recovery

I know it hasn't been that long since I gave you guys an update on my leg but today is eight weeks and I figured I would celebrate the small victories. Eight weeks is significant when it comes to healing because of the general belief that a bone will be healed enough to walk on by six to eight weeks. Obviously this depends somewhat on the person but that is the general rule. Children heal much faster and older people and smokers of any age heal far slower. But since I'm not fitting into any of those categories I figure I'm probably following the normal course.

I've noticed that my attitude towards my foot has certainly changed in the last couple of weeks. Right after the break I was practically panicked if my foot hit the floor incorrectly or went for any time without the boot. I hated to touch it down for any length of time and was worried sick if it wasn't up for a while. In short, I was a basket case.

The last four weeks or so have seen me really calm down about it. For starters the break feels more like a part of my life and less like something that is temporary. I've gotten used to my injured foot, the boot, and the crutches. I can no longer remember what it was like when I was walking. You would think that this would depress me but instead I've found some peace in it. Secondly I've stopped worrying about injuring it further. I now walk with it down all the time and am putting more and more weight on it. I'm no longer even phased if I run it into a door or someone kicks it. I'm very stable on the crutches now and find them a comfort rather than a nuisance. All and all, I've grown used to things and am starting to feel like my foot is pretty much healed.

That said I go to the doctor next Monday. And I have a feeling things will change again. I'll either end up being able to put more weight on the foot or losing either my boot or crutches. And this of course will throw me back into chaos. I'll have to learn a whole new skill. But I figure I've learned each task without too much trouble. I've adapted to each step and have grown comfortable. The next appointment is just another step in the road to recovery. My ankle feels stronger. I feel stronger. I just have to make sure I don't get my hopes up. I may be cursing the boot or crutches next week. It's all about change.