A Shiny New Ankle – Part II

 

This blog is the second about my new ankle. Observant readers of the earlier “A Shiny New Ankle – Part I may remember that I slept through all the important parts of my recent surgery, hence I know little about what really happened. That, of course, is no obstacle for a two-part blog since talking about myself is one of the few skills that I possess. This blog is an excuse, then, to talk about doctors and surgeries and such things, despite my unconscious state during most of my hospital stay. Further, I was never given a precise understanding about the nature of the surgery beyond the promise from the surgeon that “it shouldn’t hurt any more after the surgery” as he consoled me about my years long discomfort that I had explained in a lengthy monologue in his office.

I should have realized that the surgeon’s earlier remark about no pain wasn’t strictly true when I was pushed out of the hospital in a wheelchair and then rolled into my vehicle with a football sized bandage wrapped around my new ankle. Maybe he meant to say, ‘while you are under anesthesia it won’t hurt,’ as was the case.

Now that I am two plus weeks past the surgery, I have developed some new understanding that I want to share with you.

1.     The surgery was the easy part.

2.     The recovery is much harder.

The truth of the recovery phase became apparent when the Missus and I arrived home and I began use of my newly acquired walker that the doctor was insistent I use every waking hour. The aim, he explained, was to keep my surgical foot suspended in the air, avoiding even the hint of putting any load on it while using the walker. Determined to follow doctor’s orders, I slid my butt to the edge of the car seat with my good foot dangling a foot or so above the ground and my surgical foot even higher. The thought that came to mind was “UMMM. This may be a bit trickier than I thought.” Fortunately, my ever-present Nurse Marjorie recognized the dilemma, and for the first of many times that day saw to it that I gently eased my good foot to the ground while keeping my surgical foot airborne. While I stood on one foot, she unfolded my trusty walker in front of me and I began what has seemed like a life-long journey hopping on one foot.

The first part of that journey began with the maneuver to step away from the truck, and then getting in the appropriate posture and direction for the short trip to the front door. One does all these maneuvers by hopping on one foot. Three hops for a 90-degree turn, six hops for the 180 turn that was required to pass by the front of the truck on the way to my front sidewalk. Fortunately, the sidewalk was relatively clean with only a little mud from my last feeble attempt at maintenance. I successfully passed by the mud in no more than two dozen hops-- enough to make me winded when I reached the steps to our front porch and the front door just beyond. As I arrived, a sudden realization hit me. I had no idea how to climb the steps using my walker. For a brief moment I considered ignoring the doctor’s admonition, but Nurse Marjorie couldn’t abide such a thought when I mentioned it.

The idea struck me that, given my posture of leaning forward over the walker, hopping onto the steps backward might be just the ticket to ease into the climbing mode. Without explaining my notion to the nurse, I did my six-hop pirouette until I could feel the first step pushing into my leg. I leaned forward, then hopped (backward). Almost remarkably, I gained admittance to the first step. It was easy, just as I had expected. Immediately thereafter I tried the second step and gained it almost as easily. The third step was a different story. Unbeknownst to me, the third of the five steps had a higher rise than the first two. This time when I hopped my heel caught the front of the third step and I nearly stumbled, catching myself by lowering my surgical foot to the ground. Of course, Nurse Marjorie saw the entire encounter and asked how I expected to continue backwards. I deliberated only for a moment with the sudden realization that the backwards idea wasn’t so hot after all.

I decided to start over. The remedy required that I hop back down the three steps that I had gained, followed by the six-step pirouette to face the steps. I was ready to try another approach – this time sans the walker. I passed the walker to Marjorie and then applied a death grip to the two railings on either side of the steps. After the requisite gnashing of teeth, I began hopping. This time frontwards with a clear view of the steps. I made it. After a short rest stop at the top, I finally gained admission to the front door.

Once indoors I made a beeline toward my easy chair, hopping, of course. By the time I eased my bulk into the chair I was winded a second time and it felt pretty good to rest my foot and leg on the extended footrest. I spent most of the rest of that day in that position with only negligible pain. I mumbled to Marjorie that this recovery thing wouldn’t be so bad, it seemed. The only remaining challenge for day one was to undress and then climb into bed with the behemoth bandage still attached to the bottom of my surgical leg just as the doctor had insisted. I tried to forget about it as I lay quietly before sleep. Sometime in the middle of the night, the bandage came back to haunt me. In my drugged state I was in the middle of a Stephen King novel where the protagonist (he looked a lot like me) was struggling with an unwanted growth on his right foot. He was determined to rid himself of the outrage, finally yielding to the notion of simply cutting the thing off with a large butcher knife.

And then I woke up. I had the sheets and a blanket inextricably wrapped around my football ankle and I was sweating after my fight with the bedclothes. Thus ended my first day of recovery.

As the second day after surgery blossomed so did the pain from my football wrapped ankle. The sudden waves of pain seemed a mystery. And then I remembered the surgical nurse saying that the anesthesia should remain effective for 24 hours … that was yesterday, and the day two morning was about the 24-hour due date. After a few minutes of the pain waves, I had a sudden urge to begin counting the pain pills that had been prescribed for me. Fortunately, the pills were effective, and I stumbled (make that hopped) through the rest of day two, being waited on hand and foot by Nurse Marjorie.

The following 10 days passed by in similar fashion until it was time to re-visit the doctor and have the football removed so that my foot was visible for the first time since the surgery. The nurse seemed unusually pleasant as she removed the outer layer of the bandage to reveal a thick layer of cotton hiding my foot. As she worked, the reason for the cotton became apparent; it was to prevent a puddle of blood from becoming visible at each of the three incisions. Apparently, the nurse expected such things as she quickly removed the cotton to expose the incisions; a six incher on top of my ankle, a four incher on the side, and a one incher at the very bottom of my foot, directly below the six incher.

The nurse kindly pointed out the sutures that consisted of both staples and stitches. She quickly bent to the task of removing the staples with a tool that looked an awfully lot like a pair of pliers.

“All finished?” I asked hopefully.

“No. I have to remove the sutures now,” she said. “Then I’ll go get the doctor to examine your foot.”

The doctor arrived shortly. He also seemed unusually cheerful as he bent over for an intense examination of my foot. Somehow, he was able to ignore the bruising of my toes, the swollen state of the foot from my toes to my heel, the drops of dried blood that remained at the edges of the incisions, and the already apparent scaring at the incisions that were almost closed. He looked at me with a smile. “Your foot looks good,” he said. “I don’t see any problems so you can move into the next phase of your recovery.” I wondered about the doctor’s vision as he continued.

“So, the nurse will finish cleaning up your foot and you will go to the office with the sign ‘Bracing’ and they will fix you up with a boot that you will wear for the next four to six weeks. He went on explain about the boot and the need to wear it every day, all day long with the walker.

I should have remained silent but honesty and my curiosity overwhelmed me. “In bed?” I asked.

“That is what I would prefer,” he said.

Here I am in my new boot for phase two of my recovery. You can see that I won’t be dancing for awhile. Maybe you’ll hear me as I clunk around with the boot and the walker.

 

 

 

A New Ankle

 

 

I had a shiny, brand-new ankle installed yesterday, so I thought I would tell you all about it.

Here’s the story.

About five years ago, at my annual physical with my local sawbones, I pointed out the swelling of my right ankle. He asked me to remove my left-hand shoe and sock. I thought he had possibly misunderstood about the right ankle until I realized he wanted to compare the two ankles side-by- side.

“Looks like arthritis,” he said. The truth of my dear old dad’s observation suddenly hit me. Dad said that the entire Eyetis family was no good, but Arthur was the worst of the bunch. He was correct. Now, fast forward fifty years for a 7:00 am appointment to replace my ankle at the Charlevoix Munson hospital.

I arrived early. I had faithfully followed their rule about consuming no food nor water since 12 PM the preceding night. I also was required to observe the hospital’s admonition of no booze for the preceding 24 hours, and I had a poor sleep during the night so you can imagine my mood when the cheery hospital receptionist enquired at precisely 7:00 AM, ‘And how are we doing this morning?”

I can’t remember my answer but apparently, I passed her test because she told me to have a seat and a nurse would accost me shortly (make that, assist me). She did. This nurse turned out to be a pleasant, matronly type who was full of information and had the patience to answer each of my questions, including the one about roofs in Charlevoix (more about this later). She led me to my room and indicated a chair for Marjorie while I was assigned to the bed. Next, she told me to take my clothes off. I thought it was a little soon since we had only just met. Her intent became clearer when she pointed at the hospital gown I was to wear. This hospital-supplied gown that was one of those guaranteed to fall open at the back upon my standing upright. Marjorie helped button up the back as best she could, given the absence of enough snaps to do a creditable job. To maintain some small measure of my quickly falling dignity, I slipped my pants back in place when the nurse said I could keep on my underwear and pants, at least temporarily.

 

The only unfortunate part of the encounter with the lady herein known as MY NURSE was when she repeated the list of questions that I had already answered at least twice on the phone as well as a few of the questions given by the receptionist 20 minutes earlier, including the one about which ankle needed repair. Then she gave me a pen and told me to write on my skin the word YES on the ankle to be replaced.

Several other nurses arrived over the next hour; each with some role to play in the process of my surgery and or recovery. MY NURSE stayed in the room and introduced each of the newcomers, seeming to watch over the tasks performed by these newbies.

Among the newcomers was the physical therapy nurse who talked about using the walker I was told to bring. She said I should show her how I could use the walker by traipsing around the room with my right foot held airborne as it would need to be positioned after my surgery. I did. After a moment or two she seemed satisfied with my performance and then she announced, “Lets see how you do in the bathroom. Is it time for you to urinate?” I must have said yes because she pushed open the bathroom door and stood aside as I entered. I didn’t know that both she and MY NURSE were going to crowd around me as I faced the toilet with the fall-away robe. Of course, I had to lift the robe to do my business, a business that was becoming nearly impossible since this was the first time in my life that I could recall having an audience to watch a strictly private matter.

I thought I had chosen an appropriate attire in selecting my gym pants with the large leg openings to accommodate a bandaged ankle. I was wrong. These pants had no fly, normally not a problem as I typically lowered the front part of the pants just enough to expose my nether regions to allow unobstructed urine flow. But I had never before had an audience. I did the only thing I could think of: I turned my back on the women, fiddled for a moment with my pants as I pretended to lower the front part, and then made a show and flushed the toilet, me assuming I could manage the not-going-to-the-toilet until after the surgery. I turned around with a smile, “I’m done,” I announced. It must have been convincing to the therapy nurse as she had no more demands of me.

The doctor arrived in my room sometime after the toilet fiasco and the departure of the therapy nurse. I didn’t know it was the doctor who was about to cut open my leg and foot. He had obviously just arrived as he was wearing dungarees and an outdoors jacket with nothing to suggest his doctoring business. I assumed he may have been a hospital maintenance man, coming into the room to check some of the gadgets that adorned the room’s walls. I finally realized he was THE MAN when he turned to me and asked “So which ankle are we doing today?” Upon my answer he quickly produced his own pen and bent to write something just above my YES on my ankle. Of course, it was illegible, but I felt relieved just the same.

After the doctor left to change into his scrubs and wash his hands, two more nurses arrived. MY NURSE introduced them and the older of the two told me they were to be my anesthetists. Two of them! One was the official anesthetist who directed the work of the other who proceeded to check the electrical terminals that my nurse had established for blood pressure, oxygen, etc.  The head anesthetist explained that she would give me separate doses of medicine for relaxation, and then numb my leg and ankle by a shot in the back of my leg as well as a general anesthesia injection. She explained the intent was not to render me unconscious but rather to begin the process for pain control both during and after surgery. She said that the amount of the anesthesia needed was her best guess since the effectiveness varied from patient to patient depending upon numerous factors. She said her intent was to provide pain relief for 24 hours. I appreciated her honesty even though it was a bit disconcerting to understand she had control of me for the next 24 hours via the correct assessment of the amount of medicine.

Then, an orderly came into the room and the group wheeled me into the surgery room where awaited my doctor; now adorned in a patterned blue set of surgical scrubs. No sooner had I arrived when the anesthetist team went into action, seeming to take turns in probing my body where they inserted their needles and administered their shots including one that required me to turn over for a shot in the back of my leg. As soon as I returned to lay on my back the medicine did its job and I went to sleep.

That’s it. I remember nothing about my surgery. I don’t know if I passed gas during the procedure where everyone in the room laughed or I just lay there like a lifeless body going through the automatic business of breathing, pumping blood and so forth. All I know is that I woke up in my room blissfully snoring away being attended by MY NURSE, My leg was different, now wrapped in giant bandage that extended from my knee to my toes that were barely visible. Somebody was an expert in bandaging while the patient was asleep, offering neither help nor resistance to the intricate job of disguising any mistakes made in lacerating my flesh, drilling holes in my bones, and putting everything back together after the surgeon had added titanium rods to my bones and inserted a new plastic gimmick to replace the outdated, worn-out ankle bone. Oh, he also told Marjorie that he stretched my foot ligament to fix my shrunken remnant that occurred from a five-year stint of insufficient activity in keeping my foot straight.

Their conversation occurred during my absence while someone, presumably a nurse, spent her time fashioning my bandage. Marjorie reported that the doctor said he was happy with the outcome of the surgery. He said everything worked to his satisfaction and that he expected I would be happy with the outcome as well. They seemed to have had a happy conversation that I missed. I am sure I would have been happy as well.

And now I am home, staring at football-sized bandage adorning my lower leg. The contraption is more than just a bandage. It is rather a combination leg-iron, boat anchor, and general inhibitor to the process of using a walker to remain upright while hopping on one leg and pushing a four-legged walker to move from place to place in our house. Despite this description of using the walker, it is not a fun tool. I am unable to manage any steps up or down a staircase, although I can manage to climb into and out of our smaller truck and I can negotiate the five small steps to our front door. I am scheduled for another doctor visit on October 25 when the current hard cast will be removed to be replaced by a walking boot.

Now, about the roofs in Charlevoix.

Charlevoix is a pleasant city adorning the west coast of Michigan. The hospital sits among a series of expensive, lake front homes on the shore of Lake Michigan. The town looks, and is prosperous. One of the distinguishing features of the town is the number of attractive ‘mushroom homes.’ These homes feature the use of thatched roofs made of water reed, a coarse weed with tubular stems that are water and temperature resistant when compressed into a thick roofing material. These roofs are highly praised in Europe, especially in Ireland where the weeds grow and where thatchers are skilled workmen who can fashion attractive and gently curving roofs in the shape of mushroom heads that adorn dormers or other roof features.

We drove around town before my surgery and found a number of beautiful homes with gently curving roofs. MY NURSE said her brother was a contractor with several clients who asked for thatched roofing for use on their Charlevoix homes.

 

               Changing Seasons

 

As time marches on, sometimes it seems to stumble a bit and I feel compelled to write about it. This is one of those times. The specifics of the stumble are this: Most of the last several months proceeded in an orderly fashion and I came to expect ongoing summertime outdoor temperatures ranging from the low sixties to the high eighties. Pretty normal and pretty pleasant for our summer despite the absence of enough rainfall. And then Bam! Fall hit us, almost without warning. I wasn’t ready. None of my warmer fall clothes were arranged in neat piles in my closet, none of my outdoor fall jobs had been completed (nor even started for that matter), as I watched summer dissolve without the slightest concern that time was running short.

I was cruising along in complete and utter disregard of the calendar and the evidence at hand. I should have heeded the example of our resident hummingbirds. About ten days ago, our pair began a sudden feeding frenzy, flitting from flower to flower incessantly over the course of several days. And then they were gone. No doubt the pair are now basking in the warm glow of the sun in some distant vacation mecca, chuckling about those of us too dumb to make advance preparations for the impending gloom of winter.

Our temperatures have plummeted. Now I arise each morning and my first question is, ‘how much frost did we get last night?’ It is a dumb question made more so by the overwhelming evidence of dead and rotting flowers in each of our outdoor pots. Emptying these pots should be high on my priority job list but I am now away from home and the temptation to get my house in order is a somewhat distant memory. “I’ll get to it when I get home,” is the excuse that I use to calm any disturbing thoughts about a stitch in time saves nine.

Yes, the Missus and I are on our final camping trip of the year, too engaged in a summertime ritual to bother about little things like an orderly, neat garden. We have, however, found time to discuss all the jobs that need doing upon our return. Sadly, the list is even longer than I expected as we have added the cleaning and winterizing of our camper to the list. This is not a trivial undertaking since the trailer is new and we are determined to make a valiant effort in following at least some of the recommendations of the trailer manufacturer about cleaning the trailer roof and exterior. (Those darn bugs have accumulated and are now decorating the trailer’s frontispiece.)

I am finding that life can be difficult in that way. Not about too much work, but more about making decisions concerning which things must be done, and which can be conveniently dismissed by forgetting, or my favorite, failing to complete a task because some other task takes precedence. Besides, there are only so many wonderful fall days on the calendar remaining and too few days of the breath-taking color that demand a car ride through the woods or some other partaking of leisure. In the final analysis It is likely that I’ll skip a few of the tedious jobs in favor of tasting a few more of the warmer, leisurely days before winter sets in with its white blankness of snow and honest to God cold that is mind-numbingly-painful for an older dude, not that it applies to me, of course.

So, I’ll probably decide that watching the seasons change is an important treat worthy of finding another excuse or two to justify my leisure time this fall. Now, I need to convince the Missus.