Tag: Dr. Ibrahim

Again with the Ankle

I’ll shut up about my ankle soon, I promise.

In the meantime, if you want to read about how I broke it, go here.

If you want to read about the first couple of weeks with a busted ankle, check this out.

If you want to know the rest of the (sadly, increasingly dull) story, you’ve come to the right place.

I spent the first couple of weeks of my pseudo-convalescence trying to get a Medical Absence Form filled out. I wanted to know the surgeon’s official opinion on whether I could continue to work, and if so, how. My place of employment wanted to know too.

This is where somebody like Jackie Chan and me differ. Jackie Chan broke his foot on the set of Rumble in the Bronx. Like me, he was told to keep his weight off that foot for several weeks. Unlike me, he had a film to finish. So he simply returned to the set of Rumble in the Bronx, painted his cast to look like a sneaker, and got on with the job.

You won’t see a broken ankle slowing this guy down

I, on the other hand, had no interest in hobbling into work every day on a broken ankle. The last thing I wanted to do was re-injure it and make it worse. So I sat in my basement and pestered the surgeon’s office. I suggested emailing the Medical Absence Form to the office so that the surgeon could fill it out and they could email it back to me and I could forward it to work.

“We don’t have email,” a woman at the surgeon’s office told me.

“You don’t have email?” I couldn’t believe it. “How is that possible in 2017?”

“You’d have to ask the IT department.”

“What do you have an IT department for if you don’t have email?” I asked, though of course just because they don’t have email doesn’t mean they don’t have computers and other IT paraphernalia.

The woman I was talking to turned sullen, and it occurred to me that maybe I’d been rude. Which, apart from being uncalled for, probably wouldn’t help my cause any.

“How do I get you the form?” I asked.

“Drop it off,” she suggested.

“I have a broken ankle,” I reminded her. “I’m not exactly mobile.”

“Jackie Chan would drop it off,” she told me. “He’d paint his cast to look like a sneaker and run all the way here and drop it off and then run all the way home again.”

I could believe that.

She didn’t really say that, of course. What she actually said was, “Fax it.”

Which sounded like ancient technology to me, like something people did back in, say, the Twentieth Century. I couldn’t help but wonder if this reflected my surgeon’s approach toward medicine. Had he reset my broken tibia and fibula with ancient Roman bone levers? Had he cauterized my wounds with rusting iron tile cauteries? If I peeked, would I find leeches beneath my cast?

“Fax it is,” I agreed, with no real choice in the matter.

Fortunately, I was able to find a free fax service online, and a mere two weeks after my surgery I was informed that I could either stop work altogether, or work from home. Seeing as I had already been working from home since the Monday following the accident, I opted to keep working. Because I was working from home, it wasn’t even necessary to paint my cast to look like a sneaker.

My first follow-up appointment was scheduled roughly two weeks after the accident. My wife and I arrived at the Fracture Clinic twenty minutes early. To my surprise, they took me in for an X-ray right away, and as soon as they finished snapping photos of my broken bones they led me to an examination room. Within minutes a technician showed up and called up my X-Rays. Seconds later another technician cut off my cast. The place was a model of efficiency. During a brief lull, I snapped several pictures of the X-Rays with my phone. (Later, someone called me on my camera. What a crazy, mixed up world we live in.)

With the cast off, I admired my injured foot. It was one damned ugly appendage. It was so ugly it was beautiful. It was swollen, blistered, battered and bruised. Rows of stitches over the ankle on either side made it look like the work of Frankenstein (I mean the mad scientist, not his monster, for those of you who care about such distinctions). A massive red bruise marred the right side of my foot from the ankle almost to the toes. Another bruise covered the heel on the left side. Four ugly red blisters decorated the right side. Later, at home, both my daughters refused to look at my foot after an initial glimpse. (Naturally, I wanted to show it to everyone. Only herculean self-control has prevented me from posting pictures of it here.)

A slim, well-dressed man with curly black hair showed up and began riffling through a folder presumably containing information about me.

“So, what happened to you?” he asked me.

“Slipped on ice,” I told him.

“Who’s your doctor?”

“Dr. Ibrahim.”

“Oh, that guy,” he said.

I was confused. “Aren’t you him?”

“Yes,” he admitted, with a chuckle.

A comedian, I thought. Good. I’d been afraid he’d be aloof and impatient. I had several questions, some of which had already been answered, such as when would the cast come off (it just had), and what hardware had he placed in my foot (the X-ray clearly indicated nine screws, one plate, and zero screwdrivers).

He answered all my questions patiently, such as which bones were broken, how long I should keep my weight off that foot (four weeks), and when I should come back for another appointment (also four weeks).

Business was booming, so he left to see one of his other many patients, and a young woman in scrubs showed up. Her name was Francesca. I assumed she was a nurse, but she was actually a student training to become a medical technician. Student or not, her job was to pluck the twenty-seven staples out of either side of my leg that Dr. Ibrahim had thoughtfully inserted there.

“Does that hurt?” she asked, digging a particularly stubborn staple out of my ankle.

“No,” I lied, effectively giving her license to dig even deeper for the next one.

Another technician arrived with an enormous big black boot called an Air Cast, all rigid plastic and Velcro. It came with a thick white sock and something resembling a sock but much looser with a hole where the toes were supposed to be. “Use the loose one until the swelling goes down,” the technician told me.

As I write this, seven weeks since breaking my ankle, the swelling has yet to go down. I switched to the tighter sock eventually anyway (okay, the swelling did go down somewhat).

She also gave me a small rubber bulb with a spout on either end used to pump air into (or remove air from) the cast, to make the cast more comfortable (they don’t call it an Air Cast for nothing). I only ever did this a handful of times. Most of the time it seemed fine the way it was.

The Air Cast was a Godsend. Whoever invented it should receive the Nobel Prize. My foot felt Protected in that thing with a capital P. There was no chafing, allowing my blisters to heal properly. I could take it off whenever I wanted to, which I did when sitting for any period of time. After a while I began taking it off at night while sleeping, because if you think wearing socks while sleeping is ridiculous, try sleeping with an Air Cast. Although if I had to get up during the night, I made sure to put it back on, because apparently that’s when a lot of people re-injure themselves, thinking they can hop the few steps to the bathroom without their Air Cast, and then they trip or stumble and break their fragile ankle again and it’s right back to square one.

The next several weeks were a blur. Working from home kept me busy, and as I’ve mentioned before, I assumed most of the cooking chores while my wife took over chores requiring actual mobility, such as walking the dog and chauffeuring our daughters around.

Fast forward four weeks to my next follow-up appointment. Another quick, efficient visit. X-Rays and a short chat with Dr. Ibrahim. My foot was healing just fine. Dr. Ibrahim told me that I should start putting weight on it right away. This would allow me to return to work. I was to stop wearing the Air Cast at home, but continue wearing it outside, but spend the next week and a half gradually weaning myself entirely off both the crutches and the Air Cast.

At home, I took off the cast. I had a pretty pronounced limp but I had no trouble getting around. On Saturday, I took a shower without having to sit down for the first time in six weeks. Glorious! I put the cast back on and took a single crutch with me out to run a few errands, including groceries. I had no trouble walking around with only the cast. On Monday, I wore the cast to work, but took a crutch with me just in case. No problem. Tuesday, I left the crutch at home. Friday, I awoke to find that it had snowed, and there were patches of ice on the ground. I figured the air cast would be more dangerous than wearing a normal winter boot (no traction), so I went to work in normal boots with no cast. It was great wearing normal shoes around the Broadcast Centre.

I’ve now been back to work just over a week. Now that I’m putting weight on my foot, it throbs a bit just about all the time. As I mentioned earlier, it’s still slightly swollen. The bruises are gone, but the blisters have yet to fully heal. I have a fairly pronounced limp, especially after walking for a while. I’ve started physio, but haven’t gone enough to see any real impact.

The journey’s not over yet. Right now I feel like I’ll have a permanent limp and I wonder if I’ll ever be able to run again. Of course I’ll be able to, I tell myself; it just doesn’t feel like it right now. But I’m upright, and walking on two feet, and that’s good enough for now.

I remind myself that we’re just talking about a broken ankle here. To get a sense of perspective, take a look at Jackie Chan’s blooper reel. He’s broken his ankle at least twice and let’s not even get started on his many other crazy injuries.

And then there’s Evel Knievel. According to the Guinness Book of World Records, Evel Knievel suffered 433 bone fractures performing 75 motorcycles jumps. He says he only broke 35 bones, but still. He spent a total of 34 months recovering in hospitals.

What’s a mere broken ankle compared to all that?

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…

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