17 August 2022
This isn’t an adventure, or at least not the sort of adventure anyone would choose to have. However it’s certainly been a learning experience so far as well as an ongoing test of endurance and resilience, both mental and physical. It’s now over eleven weeks since my unstable right ankle fracture sustained while backpacking in the Outer Hebrides and my amazingly rapid rescue by coastguard helicopter. It’s a day over nine weeks since my open reduction and internal fixation with a titanium plate and six screws. Hence it seemed appropriate to give an update.
After flying home and review in Exeter, I had to wait for the blisters round the fracture site to heal and the swelling to reduce as much as possible, in order to minimise risk of surgical complications. That’s why the surgery was delayed to 14th June. Of course I was non weight bearing and my ankle was splinted in an orthopaedic boot and then a back slab.
My time was spent in bed at home, once I returned from Scotland, with my foot on 3-4 pillows while I read, watched iplayer and tried my hand at various free Open University modules – these included topics as diverse as the body in antiquity; health and well being in the ancient World; sustainability topics; ecological and climate change issues; renewable energy; World religions; sports psychology – including burn-out, development of resilience and sports injuries; why maps are made; and how to write about “what you know”. All were very informative and interesting. In the evenings, for a change of scenery, I shuffled downstairs and sat on a reclining chair with my foot on extra pillows. The constant elevation in a back slab continued for two weeks after surgery, so it was just over four weeks of non weight bearing in total.
Things improved a bit after that. The back slab was removed, the stitches taken out of the well healed wound and I was given a different sort of walking boot with instructions to partially weight bear using two crutches but only with the boot on. The strict elevation rule was removed. At first, any walking was very difficult. I still couldn’t manage to get in or out through the front door except with the help of a chair to transfer. My first walk outside was only a few hundred metres and that was very difficult. However I persisted and gradually increased my walking distance and speed. At the end of four weeks, I had been on walks of up to almost five miles and increased my speed to three miles an hour, limited more by my wrists aching on the crutches than pain in my ankle. I even kept up my speed going uphill, which did give me an aerobic workout. I wore my boot all the time except when I was dorsiflexing and plantar flexing at the ankle joint while I was sitting with my foot elevated in a chair. The boot became very sweaty so had to be washed and dried during the short times when I wasn’t wearing it. By the time I returned to the clinic, the sole of the boot had worn through in places, so just as well I was to be weaned out of it.
The next step was to graduate to full weight bearing without a boot. Initially this was just inside the house and walking was almost impossible. However I gradually weaned from requiring the boot outside. It turned out that I might have to wait a while to get my NHS physio appointment and the leaflet I was given at clinic about exercises was totally overwhelming and of course not specific to my needs. Fortunately I managed to book in for some private physiotherapy at a local clinic which specialises in sports rehabilitation too. I received a list of exercises to do twice a day, all geared to my needs. The suggestion to use one crutch while trying to wean from the boot was helpful too.
My position now is that I haven’t worn the boot for over a week. I am walking for short distances without taking the crutch with me. If it’s a bit further then I take the crutch but just carry it a lot of the time and use it if I’m struggling. I’m spending at least two sessions per day of forty five minutes to an hour doing my physio exercises – the ones from the private physio plus I’ve incorporated the ones from the NHS physio into my regime now I’ve seen them too. I’ve also re-joined the gym that I stopped attending when Covid struck – at first only using the static bike but this week I’ve diversified as I can manage the rower and the cross trainer now for short periods. It’s a big commitment to exercising but hopefully it will improve my ankle mobility, strength and proprioception more quickly as well as restore some of my lost cardiovascular fitness.
Having been very independent, it is very odd to feel almost totally dependent and helpless even for only a limited period. It was interesting how I craved independence in very small activities such as trying to reach and turn on a light, moving items from one room to another of the house by carrying them in a rucksack during the time I had to use both hands for my crutches etc.. Paradoxically I was even keen to return to domestic chores. Initially this was all declined by my husband who said that it ended up creating more work rather than less!
However I am now back to almost all my chores – our cooking meals rota, definitely back on washing up duties and I’ve even managed the supermarket shop unaided as I started to drive my car again three days ago.
I am still improving noticeably every day, so I’m hoping to be able to walk properly and reliably again soon. However I need quite a few more degrees of movement of my ankle and more strength to be able to manage a normal gait, especially uphill. I am planning some adventures which will be a bit less ambitious than previously to start off. Hopefully it won’t be too long before I can manage to run again too. The thought of this is motivating me to spend all that time doing my exercises! The surgeons in Exeter certainly did their bit well and now it’s up to me (with the advice of the physios).
Where's Kathryn? 