So, the Broken Ankle Log is getting pretty long. Also, I think it’ll be good for me to start moving away from the term “broken ankle.” This probably seems silly, to worry over wording, but aren’t psychologists always going on about the importance of the language we use to talk to ourselves? So, while the bones in my ankle are not at 100%, I think it’s time to start thinking of my ankle not as broken, but as recovering. Without further ado, let’s continue on this journey!
P-S Week 5 (Week Eight)
April 2, 2009 After looking at my x-rays, the doctor said the hardware was in its place and that I had “a lot of new bone.” Yay! So I’m healing nicely. The Physician’s Assistant said the incision from surgery looked great. The ankle’s still quite stiff, but I can move it some up and down. The doc showed me how to start partial-weight bearing, that is, walking with both feet while still using crutches. While I was certainly happy to reach this stage, there’s a bit of irony here: it’s much faster to swing on the crutches using one foot! So whenever I got exasperated (especially in long hallways) I would just start swingin’ again. But the doc said to do the 2-footed hobble step (not in those words, of course) as much as possible.
I got a prescription for physical therapy, which I will probably do right there in the Detroit Medical Center’s Rehabilitation Institute; I don’t think there are physical therapy places in my neighborhood. I’m supposed to start on the stationary bike (such irony!), in a month move on to the treadmill, and hopefully after 2 months of PT, start walking on my own two feet with no other supports! I don’t know if I’ll get any of these other treatments I’ve been reading about online (such as ultrasound and ice therapy), since the only thing checked off on the prescription is “walking exercises” or something like that. I’m thinking, if they’re just gonna have me on a stationary bike or treadmill, what’s the point of going to a rehab center? I can do those things at a gym, and it would probably be cheaper to go to my university’s gym than rehab. Hm…
Physical Therapy (PT) Week 1
April 7 Today I had my evaluation with the Physical Therapist. The therapist examined my ankle, measured the amount of motion possible in degrees with a ruler-protractor thingy, and measured how swollen I was. She said I should be putting ice directly on the ankle every day. Thinking about putting ice over those screws…brrr! Next time I’ll start the actual exercises.
I’m glad the therapist is such a nice person!
Oh yeah, I restarted the numbering again. First, I just had weeks. Then, I was counting Post-Surgery Weeks. Now, it’s weeks of Physical Therapy. To use all my “calendars,” this is Week 9, P-S Week 6, PT Week 1. Lol. I won’t put all that up every week though.
PT Week 2
April 16 So I haven’t been keeping up with this mini-log. It’s the last two weeks of the semester, so things are getting nutty. Plus, I’ve got to gather paperwork for this job. But more on that later.
So far my therapy consists of warming up on a little step machine (only you use it sitting down), swaying side to side to gradually shift weight onto the recovering ankle, and manipulation of the ankle by the therapist. Recently, squats were added, as well as a step up onto a block about 3 inches high. Baby steps. There’s some other non-weight bearing exercises like trying to trace the alphabet moving just the ankle.
When all that’s done, they hook me up to a machine for some electrical stimulation. It feels like creepy-crawlies, or pins and needles. While that’s going on, I also have an ice pack on.
So far so good!
PT Week 3
April 24 Yesterday, my therapist said maybe next time I can use the stationary bike, as I must be missing bike riding. And today, I did indeed get to warm up on it! It was fun, even though it wasn’t a real bike ride.
I step up on a higher step now. I no longer do squats hanging on to a table; rather, I have an elastic around the fractured ankle giving resistance, plus have to squat down while holding a bar behind my head. When I get tired, I say to myself, Zack and Cloud wouldn’t be tired! (Such a FFVII geek!) In therapy, I even walk without the crutches (to the extent that such lurching about can be called walking, lol). Looking forward to next week!
I started putting Vitamin E Cocoa Butter on my incision scars, hopefully that’ll help them heal to a nice invisibility.
PT Week 4
May 1 Yesterday I had both a clinic visit and a physical therapy session. The doctor said I should spend no more than 3 weeks using the boot, and that I should stop wearing it at home, gradually getting back to wearing a regular shoe on that foot. I asked him if I could just stop using it now, as in therapy I feel comfortable walking (sometimes, more like lurching) around with gym shoes on both feet and without crutches. He did a sort of shoulder shrug, “sure, if you can tolerate it” type of mumble-thing. At least that’s what it seemed to me. Must’ve had something else on his mind that day.
So today I went to school using the boot, but only one crutch. That really forces you to step on the recovering leg, since with two crutches, even if you’re putting both feet on the ground, and look like you’re walking with both, you can (consciously or not) actually be avoiding putting weight on the recovering leg. I’ve been leaning to the left for 2 months now, it’ll be a hard habit to break!
As I walked up to my Anthro prof today to hand in my final exam, it seemed like he was staring at my booted leg. Granted, I was wearing it differently (with the pant leg rolled up, making an unabashed fashion statement!), and I got up without the crutch, but still, it made me wonder, does he think I’ve been faking all this time? Of course, I gave him the doctor’s note when I first returned to classes, but…I’m probably just being paranoid. But, I’ve got pictures of my scars to prove at least to you, O World, that I’m not faking!
PT Week 9
June 5 Wow, I went four weeks without writing anything here. It’s because I spend my lolligag time on Square-Enix Members now, lol.
Anyway, I’ve made really good progress. I’ve been walking in regular shoes and without crutches for a month now. I’m not lurching anymore, though I sometimes do limp a little. About two or three weeks ago my physical trainer said she wanted to check my hips. She said that since the muscles shrink from disuse, one side of the hips, that is, one hip bone, gets pulled up higher than the other, hence, the Frankenstein-like lurching. She did some specific stretches to realign my hip bones. About a week or so after that I got another realignment.
Today I walked for 20 minutes non-stop, a distance of about one mile. It’s been two hours, and the effort has not caused swelling, but my legs are pretty tired.
My trainer said that next week we would really pick up the pace. I only have three weeks of therapy left.
At my last doctor’s appointment, my orthopedist said that if by my next checkup I’m still unable to move my foot side to side, he could take the bottom two screws out. Normally they wouldn’t be taken out so quickly, but since…aw hell, I haven’t broken the news anywhere else. Well, I got a job overseas, and I’m leaving in August. Since the first orthopedist I saw had told me that “some screws should come out within a year,” I was worried about having the screws removed by surgeons other than the ones who put them in, to say nothing of, by surgeons whose language I speak only moderately well. So the answer was, take some out in mid-July. My trainer and therapist today said they think they’re not gonna be able to get more motion out of my ankle with that hardware in there, so I’m a bit conflicted: I would like to be normal again, and have a fuller range of motion, so taking some screws out would be good; but on the other hand (foot!), I don’t want to get cut up again so soon. And even though it is an outpatient procedure, where they just make a little hole above the screw head and unscrew it, I bet it’s not as reasonably priced as the regular office visit.
We shall see.
Whole Ordeal Week 20
July 3 Well, I finished up my physical therapy, did 12 weeks total. I had regained as much motion as possible given the hardware. For going to all my sessions, I got a certificate good for a month of free use of the Rehab Institute’s facilities. But I ended up needing to rest, and then on July 1st, I had surgery to remove the bottom-most two screws. One of them was even broken! I have no idea when that happened. I was supposed to call the Ortho clinic to schedule a post-op appointment, but the day of I was tired and in pain from the surgery, Thursday I was so drowsy from the Vicodin that I forgot to call, and today, well, the clinic must’ve been closed for the 4th of July weekend. I hope that if I call Monday I’ll be able to get an appointment for Thursday.
Anyway, for the moment I’m in an “orthopedic shoe”, which sounds more impressive than it is. But I can do weight-bearing as long as I’ve got it on, and don’t need crutches. When are the bills for this one gonna roll in, I wonder?
July 14 Yeah, so, that surgery was 17 grand. Crap. *Praying for mercy*
But I do feel better without those screws. Yesterday I went to the Rehab Institute to redeem the certificate for a free one month gym membership. I’m back to walking normally and am very grateful for that. I still go down the stairs a bit funky since I can’t easily get my knee over my toes by bending at the ankle, so I bend the knee more than usual. But it hasn’t even been 6 months yet, and from the beginning the orthopedist said it takes six months to a year to return to full normalcy.
Here’s a picture of the sutures on the medial side. They’ll get taken out on the 23rd. Now this scar looks like an anchor, or a cyclops smiling, or a computer’s power button. Take your pick.
10 Months After the Break
December 15 So it’s been ten months since the break. I can once again run normally, but since I hadn’t done it in so long, I get out of breath quickly. It’s so strange to think about the fact that I haven’t run in 10 months. Not that I was a runner before the accident, but I could run if I wanted to or needed to (and the need to run comes up a fair bit when using mass transit, lol). I also go down stairs much more normally now, though I think there’s still more bending at the knee rather than at the ankle, but it’s not as pronounced as it used to be. When I get off my bike I realize that my left leg is sore while my right leg feels normal, meaning my left leg is still doing most of the work. I have to consciously think about putting force into each stroke with my right leg.
Well, I think I should list straight out how much things cost, as that is the information most people who end up on this page are searching for. The below figures represent my case, so anyone else’s may be different. I did not have insurance at the time of the accident, so these are the prices for non-insured. If you are in the situation I was in, as much as you want this information, you may also feel daunted by it. Please do not choose to refuse care because you are scared by the cost. That said, I believe that patients have the right to know what kind of debt they are about to take on when they go into something like this. Not knowing what was coming was by and far the most nerve-wracking part of this experience. For me, once the bills started coming in and I could crunch numbers, I was able to somewhat relax and focus on my recovery. It’s important to look for help; from family, from the medical institutions themselves, and from the government. Also, keep in mind that these totals were accrued over the course of 6 months, and the bigger debts are being paid off in manageable installments. So, here’s the list of pretty much all expenses related to this accident.
- Ambulance ride (Detroit): $450
- Emergency Room: $2000
- 1st Surgery (open reduction internal fixation of bimalleolar fracture) + one night hospitalization: $34,000 (so I was told; this debt was forgiven by the hospital so I don’t know for sure.)
- Anesthesiologists (both surgeries): $3000
- X-rays (both surgeries and all clinic visits): $1500
- Doctors (ER, surgeries, and clinic visits): $850
- Radiologists (both surgeries & all clinic visits): $425
- Orthopedic Boot: $150
- Physical Therapy (3 months): $2700
- Prescription meds (painkillers & antibiotics; note that pain levels can vary considerably from person to person; only for the first two days after surgery was I taking a pain pill every 4 hours; after that, I took about 3 Vicodin a day, and shortly got down to just 1, so I didn’t have to fill many prescriptions.): $150
- 2nd surgery (removal of 2 screws): $17,000
So, the grand total that has to be paid is over $28,000. With much help from my mother, and of course, the forgiveness of the 34K from Detroit Receiving Hospital, what I owe now is around $17,000. Since I’m working in Japan now, I don’t have detailed figures anymore, as I just send money home and my mother pays the bills for me. I expect to be out of this debt in 3 years, if not sooner. Well, out of the debt to the medical institutions. Once that’s paid off, I have to pay my mother back. But, one step at a time.