This is Part 2 of my blog about my experiences and recovery after having an external Ilizarov apparatus fitted to my arthritic ankle in December 2016.
You can read Part I of this story here.
I’m now 1/4 of the way though this procedure, and at times the remaining 9 weeks seem like a lifetime. Occasionally, I’ve wondered if I’ve made the right decision getting this done, and at times I think that if I knew how hard it would be I wouldn’t have gone through with the procedure. Hopefully the end result will make it worthwhile, but only time will tell.
There isn’t really any pain most of the time, and I don’t need to keep taking pain killers every 4 hours now. In fact, occasionally I can go 24 hours without taking any Paracetamol, although I do still take OxyNorm before bed to help me get a good night’s sleep.
While there isn’t really much pain as such, it does feel rather uncomfortable sometimes – usually if I’ve been sitting up or walking, so it swells up. The feeling is like my ankle joint is being inflated and is quite unpleasant. This tends to get worse towards the end of a day, and can sometimes be helped by loosening the struts on the frame and flexing my ankle, which helps the calf muscle pump fluids around the joint. However usually only pain killers and sleep help get rid of this.
The other odd feeling is again when the pain killers wear off, and I can feel some of the wires through my heel. It isn’t really painful as such, but just feels odd and reminds me of what my poor ankle is going through. Mostly though, it doesn’t really feel like I have anything attached, although there is still a slight tingly numbness in my foot – hopefully just down to the swelling and bruising that is still there.
I’ve also decided to treat myself, and give me something to occupy my time while I’m mostly stuck at home. I used to play guitar when I was at school, and have been meaning to teach myself to play again for a few years, but never got round to it. So I’ve got myself a new guitar – a rather splendid Fender Stratocaster Jimi Hendrix edition, and will make an effort to see how much better I can become by the time the frame comes off.
It’s now a few days into week 4, and it’s New Year’s Day! This has been the quietest and most sober new year for many years, and while nice to spend some relaxing time with my girlfriend, it was rather depressing knowing I was stuck at home. But I’m hoping 2017 will be a good year for my ankle, and I’m looking forward to seeing an improvement later in the year.
A few days into January, and I’m back at the London Independent Hospital for my first physio session. I didn’t really do much other than talk through what I’d had done to my ankle and demonstrate the range of movement, but he gave me some new exercises to do 3 times a day to add to the list I already have. The following day I was back again for my next dressing change and checkup with Mr Heidari.
Most of my pin sites look great, and there’s just one that hasn’t really healed properly yet – the bottom of the 3 large pins screwed into my leg. It looks healthy though, so no one is concerned. The only downside to this is that it’s still rather painful, especially if I put too much weight on my leg, or flex it in a certain way.
I’d been slightly concerned about the numbness in my heel, but the nurse and Mr Heidari aren’t worried by it. Apparently it may not be fully healed by the time the frame comes off, but should resolve itself at some point. After getting this clean bill of health, I’m sent home an hour later with a new set of dressings fitted.
I’m now over 1/3 of the way through! One one hand it’s quite depressing knowing I still have 8 weeks to go, but the last 4 weeks have gone past fairly quickly, so I’m hoping that the next 4, and then the next 4 go quickly as well.
Not much has changed in terms of pain – most of the time it’s fine, with the pins in the heel occasionally becoming uncomfortable. The odd internal swelling sensation is also still there at times – mostly at the end of the day.
I’ve been trying to sit up more often, and see how my ankle handles blood flowing to it again. At first it would quickly turn quite purple and start throbbing (I know what you’re thinking – stop it!), and I’d have to raise it again. However after a few goes at this, it became more used to it and was more comfortable for longer periods of time. This is handy, as one of my cats has decided that my foot rest beanbag makes the perfect sleeping spot, and spends most of the day there.
It’s during this week that I probably felt the lowest that I’ve felt so far, and getting through the remaining 7 and a bit weeks seems like an impossible task. I think it’s a combination of being tired due to lack of sleep (I don’t like sleeping on my back, but it’s not that easy or comfortable to sleep on my side with the frame fitted), and feeling bored and lonely as my girlfriend has been back home in York for a week now so I’ve mostly been sat here alone.
It’s also very frustrating not being able to do so much. Even little things like opening the door to the postman and taking a parcel become logistical challenges fraught with danger, and there have been a couple of times when I’ve been trying to carry something where I’ve stumbled and nearly fallen which wouldn’t be good!
At my regular Thursday appointment for my dressings to be changed, I got chatting to another frame wearer who was there too (hi Diana!). It was nice to speak to someone else who was going through the same experience, and encouraging to know that I’m not going through this alone.
The pin sites are healing nicely, and the hematoma is improving too. I did notice some swelling on the left of my foot, but this was due to me having been sat down for a couple of hours by this point.
I also had my first x-ray since the operation, and Mr Heidari was pleased with what these showed, and confirmed that everything is looking as it should. So I felt a lot more positive as I headed home in the taxi, despite the weather being really cold and wet.
I also had some good news there, as Mr Heidari suggested that the frame be removed 1 day earlier than originally scheduled as he was no longer available on that date – woohoo!
As I head towards the half-way point, I’m realising that I’ve not really made the most of this time to myself. Before the surgery, I had planned to do all sorts of things such as catching up on reading and writing more content for my pet blog, but I’ve not done half of what I thought I would. I have been practising my guitar, using various YouTube tutorials, but I find that I’m usually too tired to concentrate enough and haven’t made that much progress.
The discomfort in my ankle has remained similar to the previous week, and I’m needing less painkillers daily. Some days in fact I don’t need to take any, although I find I sleep better if I take some before bed time. I find it quite hard to sleep at the moment, and it’s worse when it hurts.
I also managed to walk a few feet on just one crutch this week, however the further away from my other crutch I got, the more nervous I felt! It was like swimming away from the shallow end and knowing you can’t touch the bottom! It felt quite strange doing this, and I think it was just over the limit of how far I want to push it, so I’ll stick to 2 crutches from now on.
I also made it into the office for the first time since before the operation. It was great to be around people again, but felt quite overwhelming being out in the open – not surprising since I’ve been sat in my flat alone for most of the last month and a half. I’d managed to get an old pair of suit trousers modified by the local dry-cleaners, and they worked very well.
I’m now over the half-way point, and it’s all downhill from here! It’s a good feeling to know that I’m on the home straight now, and I’m feeling a lot more positive than a couple of weeks ago.
Sadly though, this was about to change – I regularly look at my lower leg and foot to keep an eye on things, and noticed one evening that there was a bit of a rash. Fortunately I was already booked in for a physio session at the hospital on the following day, so I phoned the nurses station the next morning and asked if I could pop in and see them afterwards.
I didn’t really get much out of the physio session, as until the frame comes off there isn’t much I can do other than the exercises I’m already doing. I think if I’d been lacking motivation this session would have been a good boost, but I’ve been trying hard to keep up with all my exercises every day so it was a bit wasted on me.
As soon as this finished, I hobbled along to the nurses area on the other side of the floor, and was soon seen to by one of the excellent nursing staff. They had a look at my rash, and suggested it was an allergy to the cleaning solution that they use. Mr Heidari agreed, as he advised using a saline solution instead after looking at a photo of the rash that I had sent him. The nurses recommend that I take some anti-histamines as this should help reduce it if it was an allergy.
So with a freshly washed ankle and new dressings I went home and was advised to keep an eye on things and see if it changed.
As I head towards the 2/3 mark, I’m starting to look forward to counting down the final 4 weeks until this contraption comes off.
The rash is still there, despite taking Clarityn once a day which is slightly concerning. I became even more concerned when mid-way through the week I noticed it had spread, and was starting to ooze fluid only an inch or so from one of the pin sites. I immediately called the hospital, and spoke to the Sister who suggested I come in straight away.
2 hours later, I hobbled in to the treatment room, and they had a look. A big risk with this kind of surgery is infection, especially with the open wounds and pins going into the bones. As such, the nurses were taking this very seriously, and took a swab from the fluid oozing out, and sent it to be checked. They were also concerned about how blue my foot was looking, and how cold it was to the touch. The Registered Medical Officer (RMO) was asked to have a look, and she was concerned it may be due to a blood clot in my calf. Obviously, this was pretty worrying to hear, and I was sent straight down for an Ultrasound scan.
Fortunately, the scan showed no clots, and I was told it all looked OK. A blood test also came back looking good, with no sign of any infection. I was very impressed by how quickly and efficiently they took care of me, and felt like I was in safe hands. The Sister had also spoken to Mr Heidari to advise him of the rash, and they both agreed to prescribe me with anti-biotics.
Weeks 9 to 11
Week 9 started with a trip up to see Mr Heidari at the Princess Grace hospital, as he wanted to take a look at the rash for himself. He was happy with what he saw, and thought it was a reaction to the Chlorhexidine solution that had been used to clean the pin sites each week.
I continued to take the anti-biotics, however they didn’t seem to improve the rash. On the plus side, it wasn’t getting any worse. I then decided to try another type of Hayfever tablet I had lying around which contained Cetirizine Hydrocloride. It may have been co-incidence, but after a few days the rash started to slowly fade.
I’ve also regained the feeling in the heel of my foot which is a relief, and the haematoma at the back of my foot was improving too. The area at the front of the ankle joint, where the main incision was done is still quite numb though but I think this is probably due to the swelling that’s still there.
I’m still waking up at around 3 or 4am every night, and struggling to get back to sleep. One of the worst things with having this frame fitted is the difficulty in sleeping, and being tired most of the time.
Most of the time I don’t even notice it’s there, as there’s very little pain. However when I wake up and involuntarily stretch my legs, I feel a sharp pain as the skin pulls tight against the top 3 screws. I’ve also noticed a pain inside the ankle joint which lasted a few days – this was quite worrying at this point, as I was hoping everything had healed up inside. Hopefully this isn’t a sign that these 12 weeks have been wasted… But as the 12th week approaches, the pain has faded away again.
Most days I don’t need to take pain killers – it’s just the odd day I need them. It’s strange to think that I’ve got open wounds, metal rods skewering through my foot, and pins screwed into my bone and none of it is that painful.
I still haven’t ditched the crutches – I could probably get by with one, and suspect I could even walk short distances without the help of any, however it just feels more comfortable to not put all my weight through the frame. There doesn’t seem to be any research which says full or partial weight-bearing is best, so I’ll stick with what feels right.
As my 12 weeks with this frame comes to an end, I’m counting down the days until the 2nd March when I’m booked to have this contraption removed. It’s been a very long 12 weeks – at times it has seemed like this day would never come.
There are a few things I’m really looking forward to that I’ve missed being able to do:
Having a haircut, having a shower standing up and being able to wash 3 months of dead skin off my left leg, being able to drive again. I can’t wait to get outside – even if it’s just to pop to the shops, and being able to carry something in my hands. I’m looking forward to being able to wear pants, and trousers without a zip down the side. Most of these things that I’ve always taken for granted – but I’m so looking forward to being able to do them again.
As I write this paragraph, I’ve got less than 9 hours left – out of 83 days. That’s 12 weeks – almost 3 months, and 1/4 of a year. I’ve sort of got used to having it fitted now – although when I sit and look at it, and think about it, it seems crazy that I’ve had this done. Earlier today I felt really excited about getting it removed, but a small part of me is going to miss it I think. I’m also a bit nervous about seeing whether it has made any difference. Part of me is rather pessimistic, and expecting it to be exactly the same as before – but I guess only time will tell, and at least I’ve tried.
The next instalment is here: