Jill Of Some Trades

And Master Of At Least One


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Castaway: The Final Chapter

On October 3, 2018, I was given the clearance by my doctor to take my first steps. I had already made a physio appointment for the next day to help get me moving as soon as possible. The doctor also warned me, in a slightly condescending way, that if I didn’t do what I was told, I could potentially lose mobility and flexibility in my ankle. His exact words, “We babied your ankle for six weeks. Now you have to be aggressive or you will not recover properly. You need to be out of the walking cast in one week.” Determined to show him that he misjudged me as a potential princess, I asked if I could take my first steps, then and there. He nodded and I got up, almost squealed in pain, but I wasn’t going to show any sort of emotion and then tried to walk while using my wheelchair as a crutch. I underestimated how weak I would be, how painful it was to try to walk on my now inflexible ankle and how poor my balance would be. I took my note for physio, plunked myself down in my wheelchair, and my cousin, kindly took me home. All I could think about was how was I going to take off the walking cast in a week. How was I supposed to walk more than 5 steps?

There wasn’t a lot that I could do that first day, but I committed to standing, at the very least, as often as I could, using a walker to help me maintain my balance. I only took 5 steps that day. Better than nothing but not the strides that I was hoping for either. I eagerly waited for physio the next day wondering what the difference between passive and active exercise would be. I showed up at Totem Life Science and was told to wait in my wheelchair for Katie, my physiotherapist. I wasn’t afraid of the pain that I knew would come, but I was afraid of losing my balance a little and re-injuring myself. Katie is a young, positive, skilled physiotherapist. She got me to stand, then walk around the examining table. She looked at my ankle, and showed me the passive exercises that I was supposed to do. They were the ones that I could basically do lying down. I had to rotate my ankle every hour, ten times in each direction. Point and flex the foot the same amount of times, then use an exercise band and do the same thing. I was also supposed to ice it, pretty much hourly. I walked a little more, but felt very thrown off by the cast. I started to understand why I needed to be out of it so quickly – it made me feel unbalanced and it was also hurting my hips. She told me to bring my walker, if I had one, and my running shoes the next day.

I did all of the passive exercises, every hour on the hour like I was told. I iced my ankle, and I went back to physio the next day. Katie told me when I got there, that I would be walking out the door that very day and that I was going to do physio in my running shoe. My ankle was sore, and I had my doubts, but Katie said – trust your ankle – it’s solid, remember that it will hold. So I did. I walked back and forth (with the walker) and did everything that she told me to do and being out of the cast made it so much easier. I asked what else I could do at home, aside from the passive exercises, and she said just walk as much as possible and ice my ankle as much as possible. She said try to walk without the cast when you can. I committed to doing everything that I was told to do and more. I used my mother’s walker which was way too short, when I got home and walked the corridors of the the condo. I knew that there were about 180 steps end to end, and I did the walk three times that afternoon. It hurt, more than I can tell you, but I did it. Then, I did it again, two more times that day, happy to see some progress. Over the weekend, I did it 6 laps, 4 times a day. I pushed the walker away and used I forced myself to walk to it. I did all of the passive exercises all weekend long.

When I went back to physio, Katie could see that I made a big effort and that my walking improved and I stopped using the air walker in 6 days. She was able to spend the time doing ultrasound therapy and massage versus watching me do the assigned exercises. She would add new exercises to improve my balance and my dorsiflexion (ability to move your foot upward so that it is closer to the shin which is crucial for walking). I added single leg squats, regular squats, sideways walking and balancing on my leg to my passive exercise routine. If you don’t work on dorsiflexion, you will limp, have issues walking up and down the stairs and have the potential to injure yourself. Speaking of which, within two weeks, Katie had me try the stairs. My mantra became up with the good and down with the bad. This essentially meant leading with my good foot up the stairs, and the bad foot down the stairs. Once I could figure out the stairs, I did them as often and possible and walked outside so that I could get used to different terrain. I walked as much as I possibly could.

In addition to twice weekly physio sessions, I also saw Stacy, a chiropractor, who was a great support in my recovery. She is one of the owners of Totem Life Science and referred me to Katie. She was also the person who explained to me that the intense, burning pain that I was having was nerve pain. I went to Stacy once a week for additional massage and ultrasound therapy. It really helped to speed things along. By November 5, I was able to go back to work and by December 20, Katie and Stacy both told me that I was well enough to no longer require physio. Here are some tips to remember if you are recovering from ankle surgery and starting to walk:

Everyone is different and will respond differently to treatment and physio. Not to sound cheesy, but recovery is really a marathon and not a sprint and you can’t compare where you are to someone else. Worry about your progress and only your progress.

Do your exercises at home religiously. Don’t shortchange yourself. If you do them at home, your physiotherapist can focus on the “hands-on” therapy that they are so skilled at rather than babysit you as you do the exercises you should be doing on your own. They are trained professionals and will know if you aren’t doing everything that you are supposed to at home. They notice your range of motion and gait. By ignoring the exercise, you hurt only yourself and you will have a longer recovery.

It will hurt – there is no way around that, but the ability to walk is worth it. The pain gets better in time.

You will notice huge changes the first week, and like me, you will get so excited and then….. After the first two weeks, the hard work really begins when you have to really focus on your dorsiflexion. It is the very last thing to come back, and you need to keep pushing through this part of your treatment and your progress will slow.

Lose your pride. I walked with a walker inside and outside. I used canes, had my air cast on to help keep my distance from people. One thing that I didn’t care about was how people saw me. I wanted to walk and I wanted my mobility back as quickly as possible and if it meant that people would see me in a walker, then that was fine. I also knew that I had the good fortune of knowing that my situation was temporary. Others do not have that luxury.

People watch and be sensitive – I always give up my seat on the subway to people who are older, pregnant and have mobility issues. When I was on public transit with a cane and cast, I was offered a seat maybe 60% of the time. People can be rude, but that doesn’t mean that you should be. Use your injury to be a more thoughtful rider.

When I went to my final orthopedic appointment on November 21. The doctor kept saying look at the nice veins! Your ankle looks really good! Look at the flexibility, it’s really coming. He told me that he was impressed with my progress. This was the very doctor who a few weeks early looked at me so skeptically. I wanted to say, you doubter! I showed you! Instead, I just said the truth – I had a great physiotherapist and chiropractor and I listened to them and did everything that they told me to do. My ankle gets a little stiff and sore here and there, but overall, I couldn’t be more grateful for the ability to get myself around pretty much like I used to. They say it takes a full year for the swelling to completely go away, so I’m trying to be patient.


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Cast-Away: Emergency

“Oh, I’ve never broken a bone or had an operation, ” I bragged, while walking back from lunch with a good friend of mine that I work with.  Little did I know, that 5 minutes later, that would all change for me.  Too cheap to spend $3 on a bottle of water, I walked over to the cooler to get a fill up.  I’ve done this about 100 times over the last 6.5 months at our office.  This time though, as I passed the fridge, I felt my foot slide through something, tried to catch myself, and went down really hard on my ankle.  The floor was concrete, so I knew this was not going to be good.  When I looked down, I saw a bit of water and some shredded carrots.  Yep – carrots caused this.  Anyway, a few people that I work with came over to try to help, but if you are ever in my shoes, err, cast, give yourself a minute.  It’s a shock and you are in pain, so breathe and try to move at your leisure.

I could not put any weight on my ankle, but I was still hoping for a sprain, I’ve had enough of them to know about RICE (Rest, Ice, Compression, Elevation) and that in a few weeks, I would be back to normal.  Unfortunately, it was not meant to be.  Now, my dear readers, I am going to pass along all of my wisdom to you so that you know what to do in case this ever happens to you.  You will get a first hand account of everything from the incident, to the Emergency Room, to the surgery and finally to the path to wellness.  And yes, I take questions.  I had to depend on some of my own knowledge of hospitals to being a planner and finally, to the kindness of strangers and of course, my family and friends.

The first thing that you should do if you are going to break anything that requires an ambulance is to work in a completely accessible building.  Of course, I do not.   This was not ideal, but I was in an office chair and everything worked out.  Really, the most important thing that you can do is to remain calm.  Yes, I know it hurts, but freaking out is not going to make you more comfortable – trust me.  The nice paramedics put me in a cardboard splint and they advised that if I can make it from the stretcher to a wheelchair, I may get seen faster.  Unfortunately, if you do take an ambulance to the hospital, they will not be turning the siren on.  Think of it as a good thing – your injury is not life threatening.

The most important thing that you do need is someone there with you.  I initially thought, NONO, I do not want to be a bother, but I have since rethought that bit of stupidity.  That person can help you, remember to ask things that you may not think of and advocate for you.  I have done this so often for family members that I thought I would be a pro at it.  It is different when it is you.  Also, remember when you go through emergency, you have to be patient.  You are just one of many people there who have problems, and as difficult as it is to wait, your turn will come.  I listened to the paramedics and transferred into a wheelchair as quickly as I could.  It took me three hours to get through triage and another hour after that before I was seen.

Your next step, once you get a bed is a quick look by the doctor and then you will be taken to have X-Rays.  I was very hopeful that I would just have a sprain, or at worst a break that would just need a boot.  No such luck.  I broke my ankle in a place that would require surgery.  I would need plates and pins.  They needed to reset the bone (also called a fracture reduction) where the doctor manipulates the broken ends of the bone into their original position and fixes them in place with a plaster cast, in my case.  I was given the option of morphine where I would feel the pain, but it would be over quickly. The other option was to do it under a twilight sleep where I would be given a combination of ketamine and propofol (the Michael Jackson drug) and would not remember the pain, although I would be semi-awake.  I initially was going to go with the quick and easy morphine, but my friend convinced me that the pain would not be worth it.  I did what any normal person would do, and I checked with my other friend who confirmed that I was stupid for wanting to remember the pain.

I was a little nervous about being put to sleep, if I’m being honest, and the guy in the next stretcher was screaming and moaning.  They started an IV, told me to think pleasant thoughts because I would be having vivid dreams, and warned me that I may feel a burning.  I remember the burning and initially, I didn’t feel well, but then they an oxygen mask over my face and told me that I would smell plastic but to breathe in.  I did what I was told and all I remember was seeing the prettiest most vivid colours…ever.  I saw sparkles, pick up sticks and even incomplete flags.  My friend told me that one of the nurses was wearing a t-shirt with a flag – I guess that’s where it came from.  It was the most magical 20 minutes of my life.  I remember coming to and looking down and seeing the cast they put on my leg and declaring it pretty and fluffy like a cloud.  I then said, in my outside voice, “That was fun, can we do it again????”  I was loving life, laughing and joyful, and wanted to call my sister and let her know that I was OK.  In my dreamy state, I just called whoever had the letters i and l in their name – and could feel my friend roll her eyes at me.  I was loving life.

Apparently, I was allergic to ketamine and needed Benadryl but I did not care.  I was nauseated and was still just happy to be there.  I went for more X-Rays, was given the clearance to leave the hospital with a pair of crutches, and told not to eat after midnight in case I got my call for surgery….which will take us to:

Castaway – PART 2 – The Unkindest Cut (AKA Surgery)