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Comment : Broken Talus
Posted by RDS on Mon 4:48pm 14 February 2011
Broken talus. Hawkins 1-2. Slight comminution. Surgery 5 days later 2 screws. It hurt bad. Way worse than it had before the surgery. Ask for the stronger drugs. My doc gave me the choice and I took Violin only. Bad choice. That night was horrible. Every beat of my heart sent excruciating pain. I didnít work for the first 2 weeks. Hard cast for 4 weeks. I was amazed at the amount of atrophy. My calf was smaller than my bicep. 1.5 months boot with NWB. Used knee scooter. Highly recommend it. I got a lot of stares but it is a lot easier on the body than crutches. I was driving 2 weeks after surgery with my left foot. It wasnít all that difficult and within 2-3 trips I felt completely comfortable. One caveat though is that I drove stick for a long time so my left was used to using a pedal. Ankle didnít really hurt if it was elevated. Elevation was so crucial for the first 3 months. Within minutes it would hurt if I didnít elevate it to at least hip level while sitting. The PT said that the muscles in the calf help pump blood up and since they had atrophied, the blood pooled and swelled. When I was able to use my foot the swelling went done significantly. During that time I was pretty good with doing the alphabet and I did stand on it at times. Showering was the biggest pain. I put a stool in the shower and that made a huge difference along with a good quality shower bag for my foot. Every night and morning I felt the stiffness. I tried to ice every day for the first 3-4 months. Sleeping was a big challenge early on. Sleeping on my back due to having to elevate became very uncomfortable. My back became irritated from the constant pressure. Luckily my girlfriend was phenomenal. Cooking was challenging early because standing for more than a couple minutes hurt due to the swelling but she was great. I didnít take the Vicodin or Percocet that often after the first couple of weeks but I did use it at night to help me sleep. The doc ended up giving me sleeping pills which worked better. In the beginning it gonna hurt so take the pain pills preemptively. Set your alarm during the night to take the pills before pain wakes you. Remember with narcotics they seriously stop you up so take the stool softeners. .
Luckily my job was flexible, itís a sedentary job, and there were no stairs so it wasnít too bad. I have worn tennis shoes at work despite the dress code and that is huge. The extra padding is really important. My ankle itself is definitely an issue but the atrophy in my foot was really bad. Now 6 months later I feel the pressure in my forefoot primarily when doing calf-raises. In the last couple of weeks I have noticed a significant amount of strength return to my foot though. I donít feel nearly as unsteady laterally as had been a significant problem earlier. PT is now every 4 weeks. I am not great about doing the exercises but I do things like try to balance on one foot while using the bathroom and brushing my teeth. Iíve also done things like ďdancingĒ in my office. I rock fore/aft/right/left. Biking is really great for it but I donít have easy access to a stationary and itís hard to ride at night around my place. Hiking has gotten better. Early on ľ mile was a long way now I can do a couple miles and feel good at the time. Afterwards it stiffens up but as long as I move it a lot afterwards itís not too bad. The day after doing stuff like that I am a little extra stiff. My advice is to do calf raises and balancing on your leg as early and often as possible. The challenge is balancing working it hard vs. creating irritation and swelling. Error on the side of working it hard. My PT said that the people who do best are those who push the limits on the docís recommendations. I was standing on it a couple weeks before okíd and doing calf raises early on. I figured pain now meant less in the long run. I donít know if Iíll ever be without pain and stiffness but itís getting better day by day. The PT said that 1 yr post op is really the point at which Iíll know my long term prognosis. I have been told by some that Iíll probably never be able run again but I am doing everything I can to be able to run again. Recently I ran for around a ľ mile and it felt ok. My foot didnít feel very strong and the roll-over was tough but the ankle itself didnít hurt much more the foot. I am planning on going skiing for my birthday in mid-March and hopefully it will hold up with the support of the boot. I think my endurance will be a bigger issue than the risk of hurting it.
Good luck to all of you out there going through this. It sucks at time but it does get better. I noticed a significant difference in my quality of life around the 4 month mark which was when I was using the boot and a cane though to be perfectly honest I didnít actually use either very much.
- Broken Talus - RDS Mon 14 Feb 2011
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