Monday, April 27, 2015

Two Broken Ankles Part 2

As I am writing, I thought it better to split the posts regarding my two broken ankles.  The first part of the injury was all about healing; this second focuses on rehab.

April 23rd
I went to the doctor and got clearance to put full weight on both legs. The right leg has to have the boot on for another three weeks; the doctor taught me about scar massage.  He also showed me some stretches to do to begin loosening the ligaments, tendons and muscles. I also received clearance to be physical therapy!!!

My next appointment is in three weeks; my goal is to talk into the appointment without any assistance (crutches, scooter, etc.).  I also have set a goal to start walking, daily (once I can actually walk) and to participate in a 5k the first weekend of June (if the doctor clears it).

Things I Didn't Expect
Hmmm . . . so I was pretty excited about leaving the doctor's office and knowing that I could start walking; then I stood up!  OH WOW!!!!  PAIN!!!! There wasn't actually pain in my ankles; it was pain in my feet; I felt as though my feet were going to crack; I read about it later and learned that the pain in the feet is caused by blood being pooled in the feet and also lack of usage. The other thing that shocked me was my balance; I had none. I read up on why; apparently we have something called proprioception.  The best way I can explain this is this is what tells the brain that we are safe to move; when its not safe to move (torn ligaments, tendons, broken bones, etc.), our nerves tell the brain to not worry about that limb for awhile. When it becomes safe to use that area of the body again, the neuro pathways have to be "reactivated" per say.

The other thing I found was that when I stood up I couldn't stand unassisted; my injury is different then many in that it was two limbs at once; this added an extra complication of being in a wheelchair; in other words not only were my calves losing muscle daily, but my quadriceps were atrophying daily. When I stood up the first time, I though my legs would give out on me. My sweet husband held on to me as I both worked to stand and to also have balance.

Another thing that was incredibly painful was in the standing position, the ankle is bent a tad over 90 degrees. The bone was set at a 90 degree angle which meant standing put it an incredible amount of pressure on that joint; it felt unnatural to stand and have my ankle fold. That's the best way I can describe it.

My Family
When I arrived home, I was so excited to scoot on my bum up the front porch; with being able to put weight on my legs, I could easily scoot; this lessened the stress I felt each time my sweet husband wheeled myself and that wheelchair down the four stairs (I always went to a happy place or tried to when he did this).

When I scooted into the house on my bum, my two year old shrieked with joy! My husband helped me stand, and I pivoted to sit in the wheelchair; my two year old thought it was time for me to get up and start running after her; she was pretty excited; I had to explain that I was a little slow right now and that I still had to use the wheelchair a little bit.

Other Stuff
I went into my bedroom and attempted to stand on both boots (have you ever tried that; not so easy; not only are you weak, have no balance, but then you add on the boots and the design of them. They are a little wobbly).  The doctor said to get out of the right boot as soon as possible. When my husband came home from work, he found a trail running shoe that I had (it has a stiffer sole then a normal tennis shoe).  It took about ten minutes to get it on, and it hurt; my foot was so stiff from being in the boot, that it was very difficult to actually get it into the shoe.

The other thing I found was that I was afraid to really move my ankle joint.  As the night went on I realized the bone was fine; the pain wasn't coming from the joint or bones; it all came down to soft tissues.



Exercises
Realizing that the pain wasn't the bone, but rather the soft tissue, I started to research some of the different stretches I could do to loosen up that whole area.  I found a wonderful blog of a woman's rehab on her ankle.

20 times with a count of 3 (toes toward and toes away), (toes side to side), (circles, both directions), (the alphabet), and (towel pull and push).

I have also worked on standing up for thirty seconds at a time; this is done at the kitchen counter with my wheelchair behind me; I also do it next to my bed; this is the back up just in case I fall (the first time I tried standing, I tried to stand up with the help of the crutches and ended up falling into my wheelchair.)

Whenever I transfer from the wheelchair to another position, rather than transfer, I have set the goal to stand up and pivot.  Instead of sitting in a wheelchair at the table, I stand and pivot into a dining room chair.

April 24th
I had my husband spot me as I stood up; no balance whatsoever; it was very painful to stand.
Continue exercises.

April 25th
My husband spotted me as I walked with crutches across the house, I used the crutches to go across the house anytime I left the bedroom; I did use the wheelchair  as I cooked in the kitchen; anytime I grabbed something that required standing, I wouldn't ask for help, but would do it myself.  This helped me work on balance. (Cooking is recreational therapy).

Played games with my family today; it is so nice to spend time with them.

No pain meds!!!

April 26th
Still used the wheelchair. Baked in the kitchen for my family; I got up with my two year old and my husband was able to sleep in today!!!  I made breakfast for the family.  (I haven't done that since the accident).

I walked throughout the kitchen utilizing the counters for support.  This really helped with balance; I also worked on standing without using any supports for balance.  I got dressed and stood to pull up my pants (it sounds small, but that balance took days to get back.)

My sister and her family came for dinner; I made dinner and dessert.  It was a productive day.

I played games with my family today; it was so nice to be able to be up!

The swelling was BAD today; my right foot looked like a hobbit foot.
No pain meds!!!

April 27th
Started walking today with the assistance of crutches; the balance work from the previous days has paid off; I am much more solid on the crutches. It is a nice feeling.  My two year old woke up with a fever; she is home with me today; it is the first time that I have had her on my own since the accident.  It is nice!

April 29th
I went to the Physical Therapist for the first time; most of the exercises he gave me were what I read about; with the exception of the towel work; I put a towel on the kitchen floor and while having my heel to the floor.  I move the towel side to side and forward and backward; my toes are starting to be able to curl again.

I also learned how to walk with one crutch.

Measurements:
Dorsal Flexion 1% (I guess neutral is 0%; apparently, I have a ways to go on that one)
Plantar Flexion 30% (Normal is 40%; that's doable!)

April 30th
Used one crutch; started walking without any support device!  I have to trade off periodically because my feet really start to hurt. Helped take care of my kiddos half of the day! Lifted my six month old and swayed him back and forth to get him sleep.

May 1st
Walked unassisted; Helped take care of my kiddos all day!  Lifted my six month old and walked him from the couch to his swing.

May 2nd
Continue to walk unassisted (I do use the crutches in the morning; the morning are the most difficult; my legs and feet are so tight and so sore when I put them on the ground; OUCH!). I lifted my six month old, put him in his bed, took him out of his bed and walked him from my room to the front room several times; I think next week I will be able to have both of them on my own! Yahoo!

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