Tag: ankle

Life With a Broken Ankle

As almost the entire planet probably knows by now, about five weeks ago I broke my ankle slipping on a patch of ice on the way to work. A clean break in both the tibia and fibula.  A classic example of how life can be turned upside down literally in the blink of an eye.

I wrote about the first couple of days here.

I wasn’t sure I’d write any more about it because it’s not like breaking an ankle is that unusual.  But who knows, there might be people out there breaking ankles this very moment, people soon to be confronted with vast amounts of free time to scour the internet seeking articles on “What to Expect When You Break Your Ankle”, so what the heck, I’ll pick up where I left off.

The original cast. More of a splint, really.

All things considered, I was pretty lucky. I had surgery two days after the accident. This allowed my ankle to begin healing properly almost right away. For this I must thank the Canadian Health Care System. I wasn’t required to cough up any dough, didn’t have to negotiate any labyrinthine bureaucratic hurdles. I just had to show up at the hospital when they told me to.

The surgery was pretty straightforward. Still, I was a bit nervous. I was thinking of my paternal grandfather, who died shortly after exploratory surgery for cancer back in 1954. A blood clot got him, I’m told. I didn’t really think anything like that would happen to me, but it was on my mind.

As I lay on the operating table, the nurse asked me if I had any questions. I had lots, but my brain wasn’t completely functioning.

All I came up with was, “You guys have done this sort of thing before, have you?”

“Google’d it this morning,” the nurse assured me. “We’re good to go.”

And they put me under.

I woke up later with nine screws and a plate in my ankle and much better questions on my lips, but the surgeon had left, so my questions had to wait.

Before the surgery I had worn a cast that went slightly above my knee, preventing me from being able to bend my leg. After the surgery I wore a cast that went a little more than half way up to my knee. It was a huge improvement being able to bend my leg.

I was also pleasantly surprised to find that the pain was quite manageable.  I’d heard it could be pretty bad. That’s not to say there wasn’t any, but it was more discomfort than pain per se. At times it just felt weird, making me wonder what was going on down there. I had narcotics (Oxycocet), but I never took any. Ibuprofen seemed to do the job. The cast began chafing after a couple of days. I didn’t realize it, but the chafing was doing a number on my foot. I would find out just how bad it was about a week and a half later, when they took the cast off.

More machine than man, now…

One morning several days after the surgery I woke up to find that a good portion of my leg had turned black, especially under the knee. This freaked me out. I actually looked up gangrene, just to rule that out, but it was just severe bruising. Probably because I was keeping my leg elevated and the blood had pooled toward my knee. It made bending my leg really uncomfortable. It lasted about a week before clearing up, at least on my leg. Five weeks later my foot is still bruised.

There was also quite a bit of swelling. This lasted until two or three days ago.

Sleeping was pretty uncomfortable for the first little while. I was sleeping downstairs in the guest bedroom. I could negotiate a path from the bedroom to the washroom easier down there with crutches. Also, I wouldn’t disturb my wife with all my clattering about if I had to get up in the middle of the night.

The bed in the guest bedroom, I discovered, isn’t anywhere near as comfortable as the bed in our master bedroom. (My apologies to all our guests over the years!) And having a cast on my leg didn’t help matters. I like to sleep on my side. The only way to make this comfortable with a heavy cast on one leg was to stick a pillow between my legs.

The worst, though, was the lack of mobility. I was warned not to put any weight on my bad foot. The last thing you want to do is to break it again while it’s fragile. Maybe there’s a way to get up and down stairs with crutches when you can’t put any weight on one foot, but if so, I never figured it out. I was reduced to crawling up and down the stairs on all fours. It was kind of pathetic. I felt like we had suddenly acquired another dog, and I was it. Sometimes as I crested the stairs into the kitchen I would announce my presence with a bark.

As if having to crawl up the stairs wasn’t bad enough, I couldn’t even shower by myself those first few days. Not exactly safe standing on one foot in the shower, and I had to be careful not to get the cast wet. I went several days without showering. Instead I just knelt by the tub to wash my hair and scrub my body. When my stench started knocking people standing close to me unconscious, I realized something would have to be done about this.

Coincidentally, my friend Fergus happened to have broken his ankle a couple of weeks before me. (So did two other friends—it’s been a virtual pandemic of ankle fractures this year.) Fergus suggested a stool in the shower. Myself, I thought you were supposed to dispose of stools in another part of the bathroom, but hey, whatever turns your crank. My wife borrowed a special waterproof chair for seniors from a neighbour. The chair sat half in and half out of the tub. The idea is to sit on the part outside the tub, then gradually work your way in. Fergus also mentioned something called a Seal-Tight Brownmed Cast and Bandage protector. He didn’t have much credibility with me after the stool business but I ordered one anyway and was glad I did. Between the chair and the bandage protector I was soon fit for human companionship again.

I loved the cast art, courtesy of my daughters

One day my wife arrived home with a walker she’d borrowed from someone. I liked it at first, but it required a lot of hopping on my good foot, and after three or four days of this the heel of my good foot started to hurt so bad that before long I couldn’t walk on either foot, so I reverted back to the crutches.

Crutches are great, but unfortunately you can’t really carry anything when you’re using them, unless it’s small enough to jam in your pockets. So my wife and kids had to wait on me, fetching stuff for me, carrying bowls and plates to the table during meals, and cleaning up without my help. They did all of this graciously, but I hated being dependent, and tried to refrain from asking for anything. Often I would just figure out how to carry or move something myself despite my inability to do so with ease. Which, if it was even possible, was usually time consuming, and sometimes dangerous, especially if it involved stairs.

During this period I felt a lot worse for my wife than I did for myself. Suddenly she had to do all the chauffeuring, and dog-walking, and grocery shopping, and waiting on me, in and around going to work. It wasn’t fair to her. I tried to compensate by doing most of the cooking, and cleaning up in the kitchen afterwards, which I discovered I could manage by resting my knee on a stool, or leaning on my crutches, and hopping around a lot. Of course, it still didn’t make up for everything she had to take on.

And then there was all the sitting around. I imagined I could feel my body deteriorating with the massive doses of inactivity.  Before breaking my ankle, I was reasonably active, walking the dog, doing Pilates. I was contemplating returning to Karate. That was out of the question now, and Pilates classes would have to wait. I did some Pilates lying on the floor, but I couldn’t really get into it. Not vigorous enough, for one thing. Had it been summer, I could have hobbled around outside on the crutches, but with ice still coating the sidewalks and streets, that was out of the question. Still, I did manage the odd outing, such as accompanying my wife to Costco one day, which helped shake off the cobwebs.

Many people assumed that I would have a lot of free time while recovering. That never happened. My sister and her husband immediately shipped me up a copy of Rudyard Kipling’s Tales of Horror and Fantasy, thinking that I would have all kinds of time to read now (thanks guys!) The truth is that during this entire time I continued to work. I only took one sick day, the day of the accident. After that, I worked from home. Why?

  1. Because it’s 2017
  2. Because I’m an idiot

Actually, I did this for a number of reasons. One, because it wasn’t really clear what I should do. Initially, my surgeon never gave me any instructions about work. Another surgeon told me that commuting was out of the question (my commute into Toronto is an hour and a half each way, involving busses and trains and stairs and so on), but nobody produced any paperwork to this effect until two weeks had gone by. Because of the nature of my job, I could continue to work remotely via emails, phone calls and Google Hangouts, so that’s what I did. It kept me busy, and it also kept me in the loop.  There was a lot going on, I had only been in my current position for six months, and I really didn’t want to fall behind.

(I did manage to get some of the Kipling read, though.)

That sums up the first two weeks after I broke my ankle.  Eleven days after I had my surgery, I had a follow-up appointment with the surgeon, Dr. Ibrahim.

More on that in my next post.

Don’t look too closely if you’re squeamish…

The Tale of a Busted Ankle

There are worse accidents to have, but a busted ankle is bad enough for me, thank you very much.

Ironically, it happened minutes after leaving the doctor’s office in Brooklin, north of Whitby. It was my annual physical. I’d gotten a clean bill of health, more or less. There was some blood work left to be done, but otherwise fine.

There's a broken ankle in there somewhere, desperately trying to heal

There’s a broken ankle in there somewhere, desperately trying to heal

I needed to get to work. My wife had dropped me off at the doctor’s office before going to work herself. My plan was to walk from Dr. Libby’s office, which was on Winchester near Thickson, to the other side of Brooklin, and catch either the 302 or the Go Bus on Brock Street down to the Whitby Go Train Station.

Earlier that morning, when I first stepped outside, I had been happy to see that the ice had receded. Sidewalks and roads seemed mostly clear. Still, I was careful as I walked along Winchester, sidestepping any areas that looked dangerous. It was about minus three with a light wind blowing. Not too bad a walk. When I got near the rink, I crossed to the north side, which seemed safer. At Brock, I considered whether to go north or south to find a bus stop. I crossed to the west side of Brock and decided to head north, which led into the downtown core and seemed more promising with all its shops.

I remember peering ahead, trying to spy a bus stop sign. I don’t even remember falling. I just remember suddenly finding myself flat on my ass. My backpack protected me from hitting my head. When I went to get up, I spotted my left foot, encased in an ankle high-winter boot, twisted around in the wrong direction. So twisted that I gasped aloud upon seeing it. “Aaagghh! Aaagghh!” The sight was worth a good two gasps.

I couldn’t stand on that. It was wrong. It needed to be right. I reached out, grasped the boot, and started to twist it back in the right position. It resisted, giving me time to realize that wrenching my foot back into the proper position myself was probably a bad idea.

What to do? I couldn’t stand. There was traffic along Brock but no cars stopped. There was nobody on the sidewalks. I considered trying to crawl forward along Brock with no real plan other than to move. I was, I realized, in a bit of a pickle.

Initially there was no pain. I anticipated a physical reaction, figured I’d go into some kind of shock, but having never experienced a similar injury I didn’t really know what to expect. Would I have some kind of panic attack? Right then I felt pretty calm about it all, just trying to work out some sensible course of action. I thought, maybe I should start calling for help.

I managed one half-hearted “help” before a woman stepped out of a store across the street. Traffic had paused, so she ventured into the street. “Do you need help?” she asked.

“Help!” I said. “Yes!”

She came closer, caught sight of my foot. “Oh my God,” she said.

A man came out of another store and jogged over. He wasn’t dressed for the weather. “Do you need an ambulance?” he asked.

“Yes,” I said. “I think that would be good. But you should put some clothes on.”

“I’m fine. Did you hit your head?”

“No. My backpack protected me.”

“Good. Just to be sure…” He held a finger up before my face. “Follow my finger.” He moved it back and forth. I followed it with my eyes.

“Are you a doctor?” I asked.

“No. Just had First Aid training.”

“What’s your name?” I asked him. I wanted to remember the names of the people who helped me.

“David,” he said, getting out his cell phone. He began talking to the folks at 911, got them up to speed. Then he went back into his store, quickly retrieved some coats, and covered me with them. He put some under my head too. I noticed that I was still lying on the patch of ice that had done me in. I laid my head down on the coats and felt well-looked after.

A fit, outdoorsy-type stepped up. “I’m a trained ski instructor,” he said, sounding a bit like Patrick Warburton. “I can snap that foot back into position for you if you like.”

Briefly, I considered it. For like a fraction of a second. Sure would be nice to have it facing the right way again. “I appreciate the offer,” I told him. “But I think I’ll wait for a doctor.”

He accepted that.

Another fellow seemed to take over, a younger fellow, maybe around thirty. He asked me how I was doing. I told him fine. I asked him his name. “Anthony,” he said.

“Thanks for sticking around, Anthony. Thanks everyone,” I said, craning my head around to see who else was there. I couldn’t see anyone else. Perhaps they’d moved on, confident that Anthony had everything under control.

Anthony stepped out into Brock Street and waved his arms like someone directing a plane on a runway. I don’t remember any sirens. An ambulance pulled over and two paramedics got out.

“Careful,” Anthony instructed. “Pretty icy.”

Seconds after that one of the paramedics (Derek, I learned shortly afterward) slipped and almost fell. I wondered how many others had fallen victim to that treacherous patch of ice.

Derek the paramedic cut the laces on my boot and gently removed the boot. With the boot off, it was even more obvious how badly broken my foot was. Later, a nurse would describe it as twisted 180 degrees. It was probably closer to 90 degrees in the wrong direction, but still.

“Ever broken a bone before?” the other paramedic asked me.

“No,” I told him.

“You’re handling it pretty well,” he said.

I resolved to continue handling it well.

We negotiated how to get me on a stretcher. I suggested that if they helped lift me, I could get up on my good foot and get on the stretcher. We were all concerned that my good foot would slip on the ice, but with the help of the paramedics I managed to get up and lay down on the stretcher.

“On a scale of one to ten, how’s the pain?” Derek asked me, once ensconced in the back of the ambulance.

I considered. “Four.” It was quite manageable.

“It’ll probably get worse,” Derek warned. “Any allergies?”

“Only cats.”

“I’m gonna give you some Ketorolac,” he said. “It’ll help for a bit.” He injected me with a needle.

As we drove along, again no sirens. Not a big deal, taking a guy with a broken ankle to the hospital.

In the Oshawa hospital, Derek parked my stretcher in the hall and waited with me as we waited for a room to become available. “It’s busy,” I observed. Emergency was crowded with patients and paramedics and nurses and other hospital personnel.

“Most of them don’t need to be here,” Derek told me. “You need to be here.”

After only a few short minutes someone directed Derek to push my stretcher into an emergency room. Derek and I parted ways. Two nurses took over, one experienced, the other a student. I believe the student’s name was Kristin. I don’t remember the other nurse’s name. Events get a bit blurry here, because the pain and discomfort suddenly ratcheted up enormously.

I was taken for an X-Ray. Deb, the X-Ray technician, had partially blue hair. Young and confident, she directed a team of two other technicians how to properly X-Ray my twisted foot. It took some imagination to figure out how to get the proper angles.

I lifted my head to have a look at my naked twisted foot.

“Don’t look at it,” Deb commanded.

I decided Deb was right. I didn’t need that image burned into my brain. Still, I caught a glimpse of it before lowering my head. It was so much worse than seeing it while still in the boot. I longed for a time when it would be facing the right direction again. Old enough to know how time works, I reminded myself that this too shall pass.

The pain was now a solid nine out of ten. I’d had no medication since the Ketorolac. Back in the emergency room, the experienced nurse took a look at my foot and drew the curtains. “No one needs to see that,” she remarked.

Later, Kristen, the student nurse, told me that she’d said to the other nurse, “I don’t understand why he’s not screaming his head off.”

I wasn’t screaming my head off because I was doing my best to contain it. I had one arm behind my head and my good leg drawn toward me, trying to reduce the discomfort and pain. It helped a hair, but not much. I wondered how much longer I could stand it. As long as I needed to, I decided.

Kristen started setting up an IV. The IV included both Saline and Morphine. She apologized for the needle, but it was nothing compared to the rest of the pain I was feeling. The morphine wouldn’t flow. The vein had collapsed.

“He’s in shock,” the other nurse said. She tried the other arm, then a second location on the other arm. Every vein she tried collapsed. “Three’s my max,” she said.

“Don’t give up,” I encouraged her. “Go for the gusto.”

She tried the first arm again. No luck. I was starting to feel like my luck had run out. I overheard one of the nurses say it was Friday the 13th. I’m not superstitious, particularly. Still…

“I can only stand this another seven or eight hours,” I joked.

The experienced nurse chuckled. “I’ve decided you’re my favourite patient,” she said.

“You tell all your patients that,” I said.

“No,” she said in a way that convinced me that she didn’t. Later, I would overhear several patients moaning and complaining and carrying on outrageously, and I realized that in comparison I was probably not a bad patient to have to deal with.

The nurses conferred. “We need such and such a nurse,” the experience nurse said.

“She’s been called away,” the student nurse said. “What about so and so?”

“No, not her,” the experienced nurse said in tone that suggested Dear God, no, not her. I felt like this nurse was looking out for me.

They finally got ahold of the one they were looking for, the talented IV nurse. It took her two or three tries. I believe between the three nurses it took eight or nine tries before they got a vein that didn’t collapse, before the morphine flowed.

I felt it going into my arm. “My fingers are tingling, if that’s useful information,” I said.

“Normal,” the talented needle-nurse said.

Somebody arrived with some forms. “Can you sign these?”

I signed them. Something to do with giving the hospital the right to treat me.

A doctor showed up. “We need to straighten your ankle,” he said. “I’m going to give you Fentanyl. It’s ten times stronger than morphine.”

“Go for it,” I said.

He injected it via needle. It burned going in. Later, my wife, who’s a pharmacist, reminded me that Fentanyl was the drug killing everyone in British Columbia. Of course, they weren’t using it correctly.

I became drowsy almost instantly. I closed my eyes. When I opened them again, all was quiet. I glanced at my foot. It was swathed in bandages. It was straight again. I couldn’t believe it. I had only closed my eyes for an instant.

Nurse Kristin spied me awake. “When did this happen?” I asked her, indicating my bandaged, straightened foot. “Did I lose a couple of hours?”

“It’s just been a few minutes,” she said.

I checked my watch. Time was acting funny. It was about two pm. It didn’t feel like four hours had gone by since I slipped and fell, but it had.

“A few minutes ago this room was crowded,” Kristin said. “The doctor straightened your foot and the sound it made… everyone in the room cringed. It was horrible.”

I was glad I hadn’t been awake for it.

My wife Lynda arrived. I brought her up to speed. She was (not surprisingly) sympathetic and waited patiently with me. I’d texted her earlier but she hadn’t received the text. The nurse had phoned her at work, but hadn’t talked long. “I have to go straighten his foot now,” she’d told my wife, who hurried over shortly afterwards.

I had another X-Ray from Deb and her team to see how well the doctor had done. Turned out he’d done pretty good, but the break was too bad. Both bones on either side of my ankle completely broken. I’d need surgery, followed by weeks of no weight on that foot, and then physio and several more weeks if not months of recuperation. It was a severe enough injury that the surgery had to be done pretty soon, but there were no beds left in the hospital for that night, so they sent me home.

I slept uncomfortably with a leg I couldn’t straighten because the temporary cast went up to my knee. I couldn’t get clothes on or off my bad leg and could hardly get about anywhere. I couldn’t even use the washroom properly because our bathrooms are tiny, with the tub close to the toilet. Unable straighten my leg, I had to prop my leg over the side of the tub to sit on the toilet. Hard to get a good seal that way. (Too much information, I know – sorry).

The next day, Saturday, my angel of a wife waited on me hand and foot while we waited for the hospital to call me in for day surgery, which they finally did around supper. But after three hours back at the hospital, they sent us home again. No more surgery that day.

Surgery finally happened the following day, Sunday. The surgeon inserted a long, narrow metal plate and eight screws on one side and an enormous screw on the other side. Afterward, I could bend my leg with the new cast; a huge relief.

All told, the care I received from the people in Brooklin, the paramedics, the nurses, the doctors, the technicians, Lakeridge Health, the Oshawa hospital, has been superb. The whole ordeal has been handled compassionately and professionally. I must thank especially my lovely wife Lynda, who has been nothing short of an angel throughout all of this. Honestly, I feel worse about the impact on her than I do about the impact on myself.

Surprisingly, there’s not much pain, although at night my foot sometimes winds up in a bad position, forcing me awake on the verge of a scream. During the day it’s fine, as long as I keep it elevated. I’m not sure how that’s even possible with two broken ankle bones and screws inserted into my foot, but I’ll take it. The worst is the lack of mobility. I have crutches and a rolling chair and I can hop and crawl, but what a pain in the ass. Still, it could have been much worse. Could have hit my head, or broken my hip.

It’s going to be a long road to complete recovery, but I’ll get there.

Yes, this too shall pass.

More machine than man, now…

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