getting into physical therapy

 

Physical therapy stirs up a lot for me - physically and mentally. The massaging and icing feel great - while the stretches and exercises are excruciating. In my gym-rat days I was a "pusher" - always challenging myself to spin faster, lift more, hold it longer. I was in incredible shape, but this mindset eventually led to a hip and back injury that kept me out of the gym for about 2 years, and the pain still plagues me. About a year ago, I fell deeply in love with yoga - where intuition reigns supreme, and I feel like my body and I are in a partnership, rather than in competition. Ironically, I'm in even better shape and have found a way to ease my pain...and my mind.

Physical therapy confuses me (and scares me) because it feels more like the gym than yoga - I have to push hard, do things that feel uncomfortable and wrong - in some ways not listening to what my body wants at all. Everything is unnatural, and watching my ankle (not) move is depressing. I sweat the same amount during 6 minutes on the recumbent bike as I used to during an hour of high-intensity spinning. I feel hyper-aware of the hardware inside my body (did the doc pour cement in there too????! WTF) and feel like I need a major oil lube, Tinman style.

I'm trying to find the yoga in PT - the quiet mind, breathing, and trusting my body to heal - but goddamnshitmotherfucker IT'S HARD.

i smell so bad

I don't know if I'm detoxing from all of the chemicals that have been pumped into my body the last month or so, or maybe because I'm not very mobile and have had very little exercise, but my armpits have been smelling something MEAN these last 2 weeks! Like, they stink WHILE I'm in the shower. I come out stinking, I go in stinking, all of my shirts stink. Has anybody else experienced this? I've tried using deodorant, baby powder, hydrogen peroxide, nothing at all - drinking tons of water, detox tea, green juice, veggies and fruit - my mind is blown and my pits are RANK.

I've thought about doing some saunas (my mom's got one in her back yard), but wondering if it's a good idea, considering how weird my circulation has been (also, I would probably have to bring my shower chair to her house, ugh). My blood flow seems fine when my foot is elevated, but as soon as I put it down and move around, all of the blood rushes to it and it turns purple. Here's a before/after (elevated/non-elevated):

Apparently this happens when you're still non weight-bearing because walking - applying pressure to the foot, helps to shoot the blood back up to circulate in your body. When there isn't that opposing pressure on the foot, the blood just pools.

Anyway, I stink. I don't know what to do.

more yoga after ankle surgery

I've been having a fun/hard time with yoga. Re-teaching my body how to move, awakening parts that have been asleep for a while. This weekend a 15 minute practice resulted in an hour-long nap - I guess that's how it goes. I've also been in quite a bit of pain, I'm guessing it's from the new PT stretches...trying to find a balance.

Anyway, here's what my yoga practice is looking like now:

yoga after ankle surgery

I fantasize about yoga. I dream about it at night and I watch yoga videos during the day (shout out to Tara!), trying to imagine what it would be like to do a sun salutation again, or even just a downward dog.

The first time I got on the yoga mat post-surgery felt pointless. I rolled around on my back a little like a dying bug. I tried to sit up and extend my legs out in front of me, but my right leg was misbehaving and wouldn't straighten along the floor - the muscles in my ankle, calf and thigh were too rigid and my heel was too tender. I couldn't turn around and get on hands and knees, because the top of my foot wasn't flexible enough to rest flat on the ground. So I nixed the idea - considering myself doomed to spend a full 8 weeks on my back in bed - day...after day...after day.

UNTIL NOW. Watch my video - it's about my entrance back into post-op yoga. Though very small, I can feel that these steps are wonderful ones. I hope you enjoy it, and I hope that in the vast YouTube universe, other people in my situation will as well. (Also, please forgive my hair - I was scheduled for a cut/color the day AFTER my fall and obviously had to cancel. So now I'm like 5 weeks overdue and it shows. Sorry. Please love me anyway.).

follow up #2 - GREAT NEWS

I went to the doctor yesterday for my 4 week post-op checkup and left feeling GREAT. My new x-rays showed that my bones are healing well, and doc says it's time for physical therapy - YAY!! He also said I can start stretching and moving my ankle around myself - YAY! (and ouch). Still about 4 weeks left of non-weight bearing (as originally prescribed), so I decided to go ahead and hit up the medical supply store (seriously, I had no idea those things existed) and rented this nifty little scooter. It's not covered by insurance unless you have Blue Cross which I don't, but it's only $100/month out of pocket - like a NY metrocard in the good ol days.

I'm saluting not being on crutches I think? Anyway, I feel a sense of optimism for the first time. I've been longing to go on evening walks with J in this beautiful spring weather - a ritual we've picked up in the last year or so. Yesterday I heated up my own soup while parked on Sir Scooter, which is a big step (even though J had to carry the bowl for me). The doctor even said I could try a stationary bike or swimming (oops, don't know how), or some pilates reformer exercises on low resistance. I've still gotta crutch around - up and down steps, in certain narrow spaces in the house, etc. - but in the larger scheme of things this scooter really helps out.

You know what else helps out?? YOU GUYS. Thanks so much for all of the texts, facebook messages, Instagram comments, and in-person visits - yall know who you are. I'm going to keep publishing this stuff so keep tuning in if you want to. And when I'm not writing, I'm probably just doing this:

flossing my toes

The other day I looked down and saw that my toes - or rather, in between my toes - were flaking. White flakes lined each little crevasse, the exact flakes I found on the back of my thighs and calves a few days before. A product, I think, of taking too many soapy baths and never being able to shower or properly scrub off the residue (I shower after my baths, don't you?). I was confined to the bathtub for about a month - 1 week post-fall, and nearly 3 weeks post-op...you can imagine how much soap accumulates.

Anyway, I had to ask J to clean my foot - an act that I'd rather have anybody else do (like maybe not somebody who I'd like to continue to enjoy making out with me?). He didn't blink an eye and within moments, my foot was propped up on the tub and J was flossing my toes with a washcloth. First a warm soapy one, then a cool watery one, then a warm wrung-out one. I'll admit it wasn't as humiliating as I'd anticipated - in fact it was pretty sweet.

sad leg, sad mihal

You'd think that having my leg out of the cast would have made me feel happy, but being able to see my ankle and foot - swollen, discolored, and completely unable to move - made me really really sad.

 (that's a big toeless sock the doc gave me when he took my stitches out, I kept it on a few days before trying to put on a real one - which J had to do for me)

I almost couldn't speak about my ankle or how I was doing without breaking into tears. I thought about how much time I had before I could even start to try walking (8 weeks post-op), I thought about yoga and joints and how incredible they are, I looked outside at the playground across the street and envied the little kids as they played. I couldn't move my ankle, I could hardly wiggle my toes, I felt sorry for myself...and I still slept on my back. But a week later I took off the white sticky things and was allowed to start taking showers!!!!!!!!!!!!!!!!!!!!!!!!!!!

Look at my cute little scar starting to form (the rest of that bloody-looking mess is a scab). Yes, taking showers DOES mean shaving my legs - which I did do...you're welcome. My mom hooked me up with this shower chair for old folk...

 

...and my dear J put it together for me without the back, because I really just wanted a stool. I'll tell ya, that's the best shower I ever did take. 

Mood swings continued (and keep continuing) to come and go - oscillating between feeling totally pathetic and kind of okay - I've certainly seen more tears since the accident than I have in the last few years combined. Within a few days of showering, I tried sleeping on my side - using pillows to prop my feet and legs up in various places. Though I continued to wake up several times a night, I found sleeping on my side to be a nearly orgasmic sensation. I also bought this book Mind Over Medicine by Lissa Rankin with the hopes of thinking myself better. We'll see...

follow up #1 - stitches out

I had my follow-up appointment 2 days early because I was scared that I had bloodclots in my leg. If you don't catch them they can crusade up to your lungs or heart or something and kill you. Of course, I knew I had all of the symptoms - crampy calf, shortness of breath, etc etc - and had a panic freak out while J was at a barbeque, my first time home alone. I made him miss the fight with his buddy, and instead he had to watch it with me in bed as I fell asleep and twitched and had nightmares and made him hold my hand. Anyway, I got tested for blood clots and didn't have them.

Instead of removing my non-existent blood clots, they removed my cast and took my stitches out. The stitches looked like this:

Yes, very hairy legs - you're gonna wanna take this time to get used to that. So anyway that's the outside of my right ankle, and there's a few stitches there on the front. Want to know what it looks like inside??

8 screws and 2 plates - it's an impressive sight to behold I think. After taking my stitches out, which nearly made me faint, they stuck on these little incision holders, gave me a walking boot (which I'm not allowed to walk in but I CAN take on and off), and sent me on my way. Oh what's that? You want to see the incision holder stickers?

Those gams won't get un-hairy for another little while, so I suggest you get used to it (how about our gorgeous purple wall though, right?!). 

pooping after ankle surgery

 "constipation" makes for pretty great Google image search results

Pooping after surgery is NOT something that comes easily. The anesthesia makes you constipated, the meds make you constipated, being totally immobile makes you constipated, and guess what - that stool softener they give you doesn't work for shit. Being that I'm a total health nut, and my digestion is usually pretty regular, I tried to go the natural way. If you're ever in the same boat (from surgery or just from life), here are several tips for some great pooping:

• Chia seeds: Either blend in with a smoothie or pour a few tablespoons into some OJ – great source of fiber, protein, and omega 3′s.
• Psyllium husk: My Godmamma brought this one to me. Take a teaspoon or two of this powder and stir into some OJ or water, but drink it fast because it turns into jell-o texture really fast. It’s basically just an ultra-dose of fiber.
• Massive amounts of water (mind you I could still only let out little bits of pee at a time thanks to the meds, so this option wasn't easy).
• Papaya: It’s so good for settling bellies because it’s filled with proteolytic enzymes which help with digestion. Trader Joes sells a fruit salad made of papaya, pineapple, and mago – I’ve indulged in several of those.
• Probiotics: After surgery I got several courses of antibiotics – probiotics are the antidote to those, restoring all of the good bacteria in your belly. My fav ones are by Dr. Ohhira.
• Calcium Magnesium Citrate: Magnesium itself has muscle relaxing properties and the calcium helps your body to absorb the magnesium. Take 1-2 tablespoons of this milky liquid – I buy mine from Whole Foods.

But hey guess what?! None of that healthy shit worked for me this time around. I was constipated too much for too many days (I think my first real poo happened 6 days post-op - NO BUENO). The first hardcore thing I ended up taking, recommended by my really smart nurse-cousin, was a glycerine suppository (queue Bush) – it looks like a clear ear plug and you stick it up your butt for like 30 minutes until you poop. Gross but it works...kinda. Then to really kick the bull in the balls I took these colon cleanse pills called Oxy-Powder. THEY WORK. A lot. Maybe too much, if ya catch my drift.

Ok...that's all I've gotta say about pooping (for now), bye.

the bitchiest bitch: recovering from surgery

The two weeks following surgery were the worst. Week #1 I was told to elevate my big shitty cast 23 hours a day, which basically meant I could only get up to go to the bathroom (pee, that is - still no poo) or bathe. Week #2 the rules were less stringent, but I was too weak to crutch around or do anything so it basically resembled week #1.

Bathing: J would secure a trashbag over my leg with a rubber band at the knee. He had to put it on and take it off for me because I no longer had flexibility in that leg (guess what, when you can't move your ankle, your calf and hamstring freeze up too!). He had to do the same for my underwear and pants fyi. Anyway, I'd get in the tub with one leg up (I had to face backward, with my head at the faucet, so I had surface big enough to rest by cast). I'd support myself with one hand on the bottom of the tub, hold the lufa with the other, J would squirt it with Dr. Bronner's, and I'd suds up. A broken ankle certainly takes all the joy out of bathing. Meanwhile, my left glute was on its way to becoming the strongest glute you ever did encounter.

Drugs: BIZARRE SHIT. As the side effects literature warns, I had vivid nightmares, not just at night, but the second I closed my eyes - which was often. I was afraid to sleep, I was too fucking tired to stay awake. Each day blended with each night. Sometimes my dreams scared me so much that I made J hold my hand as I dozed off, just to ground me in some kind of familiarity. He obliged with a smile because he's incredible. Also the Oxy made my body twitch like 12 times as I fell asleep - sometimes whole-body, sometimes localized - SOMETIMES in my sad outchy ankle which quite frankly killed. For the second week I was switched from Oxycodone to it's weaker - but still quite sassy - little sister, Hydrocodone. The dosage was lighter and I was pleased.

 me, feeling/looking the worst I've ever felt/looked

Food: Overall, food was not part of this whole thing - everything nauseated me. I could tolerate cucumbers, strawberries, some soups, toast, tea...and a few other things that I can't remember (I can't remember most things). Weight began to fall off of me (silver lining?).

Sleep: I was on my back with my leg propped up every night. I fantasized about turning onto my side like a dude in prison fantasizes about getting laid - J and I hadn't spooned in what felt like decades. He was also scared that he'd move in the middle of the night and pull the covers over my cast in a painful way, so I slept on top of the covers under my own blanket. I set several alarms every night for meds, and kept gluten-free crackers on my nightstand so I wouldn't be medicating on an empty stomach. I woke up every morning with soggy crackers stuck in my molars - beginning another blurry day that would soon become night.

post-op

DAY OF SURGERY: POST-OP

After surgery, they take patients to a "wake-up room", where each nurse is assigned to one patient until the patient wakes up. That's the nurse's only duty. I remember waking up and seeing a man-blur over me asking if I wanted some ice chips. "Yes." I responded for no reason.

When you're in surgery, those waiting for you get a pager and your status is updated on a screen: "in surgery", "in recovery", etc. When you're being wheeled out from the wake-up room to the room where you'll be staying, they call your name over a speaker. My dad thought they called my name when the speaker announced "Nicole" (many people botch my name by calling me Nicole), so he took his smiley, supportive face to the bedside of a girl who wasn't me. Chances are if she was in the same state I was, she didn't notice, or at least didn't remember. I was rolled out right after Nicole - I have no memory of any of this - but eventually I ended up in my room.

I could only open one eye for what felt like hours. I was exhausted, it was bright, voices were booming, I fell in and out of sleep (by the way, the first doctor I saw - the one I ended up dumping for the good one - said I would be going home right after my surgery, which I can't even imagine because I was FUCKED).

NURSES: Were for the most part awesome. There was one super bitchy lady who came to help me pee in the middle of the night and told me I had too many blankets on (I WAS FREEZING) and took them off.
PEEING: I was so parched that I was drinking (and consequently peeing) constantly, but the meds made it so I could only let out a little bit of pee at a time. The first time I peed I used a bedpan and obviously couldn't hang, because it dripped everywhere and they had to change my sheets. Gross. From that point forward I peed in a portable bucket-toilet with handrails that they brought right next to the bed and helped me get on and off of one-legged (nurses, godblessem). Since I couldn't fully empty my bladder (a side effect from the anesthesia and the other drugs I was on) I was going like once every half hour.
POOING: Ha! Yeah right. That wouldn't happen for daaaaays (more on that later).
PAIN: My leg-numbing shot wore off at about 2am, at which point I was pumped full of Oxycodone (a crazy strong oral drug) and more morphine (ugh, that fucker again). Eventually the pain was controlled with the help of my primary night nurse, though the nurse who took over for her in the morning was in her own world and wouldn't stay on top of my dosages so I - the super stoned post-op patient - had to.
DRUGS, FOOD & CRUTCHING: The Oxy made it impossible to stay awake, impossible to balance (which sucks when you're on crutches), and impossible to eat (meanwhile J was eating hospital burgers and steaks and every possible disturbing piece of meat on the menu). They had a gluten-free menu - generously speaking - and the blueberry muffins were about the only things I could stomach. Eventually a LOUD TALKING physical therapist came by to make sure I could get up and down stairs on the crutches, he tested me on a stairway to nowhere that looked like this:

I was eventually sent home that evening (a day and a half after the surgery) with prescriptions for Oxycodone and a stool softener - I was also told to take 1 Aspirin per day to prevent blood clots, and Tylenol to go with the Oxy (apparently you're not supposed to take anti-inflammatories like Ibuprofen after surgery because it slows the healing process).

I still craved strawberries.

pre-op

 DAY OF SURGERY: PRE-OP

Up until this point I'd never had surgery - never stayed in a hospital. I couldn't even remember the last time I'd been in a hospital. I had to be there at 7am on an empty stomach since midnight the night before. They gave me a backless gown (and made me take off my undies so my tush was completely out), checked my blood pressure, weighed me (when did I lose 10 lbs?? whatever, not complaining), and asked me millions of questions. In between each phase of tests and questions, J and I watched the Today Show - I mean, I looked at it blankly, petrified...too many thoughts running through my overly tired mind. I felt very down, outrageously sorry for myself, and couldn't stop thinking about Grey's Anatomy.

The nurse came by with a cocktail of pills - they explained each one, but I can't remember what any of them were, except for an anti-acid for somethingIcan'tremember. Then they asked if I was in pain...UM FUCK YES I'M IN PAIN I HAVE LIKE 3 FRACTURES IN MY ANKLE AND THE E.R. GUY SAID IT WAS ONLY ONE AND GOT MY HOPES UP AND NOW I'M ABOUT TO HAVE SURGERY AND YES I'M IN PAIN. They hooked an IV up into my hand, it stung. At that point only J had been allowed in the room with me because it was such a small space. Once the IV was in they let my dad in - when I saw him I began to cry. "Daddyyy," I wimpered like an injured puppy.

The nurse said the anesthesiologist said she could give me some morphine. Though I relished in the idea of not being in pain, the notion of hard drugs scared me. She squeezed it into my IV and I gasped with a fierce tightness in my chest. I was dying before I even got to surgery, I feared suddenly. Could morphine cause a heart attack? The nurse sat my bed more upright and the tightness subsided. Ugh. Eventually El Anesthesiologist himself came in, asked me a whole bunch of questions (ps how am I expected to know what meds I'm allergic to if I've never had surgery? seems like a flawed system), and he prepared me for how I'd feel after. My throat might be sore if they have to stick a tube down it to help me breathe. The leg-numbing shot they give me after surgery will wear off in 8-12 hours and then I'll be switched to oral and IV drugs. The numbing shot they give me could paralyze me. Standard shit, you know.

Eventually they wheeled me off - I kissed my dad, kissed J - I was frozen with fear. What if I don't wake up? What if I wake up but have no use of my foot because the nerves are fried? "Are you scared?" the anesthesiologist asked me. "Yes, very." I responded, my voice quivering. "Well if it helps, I'm not at all." That helped, and it's the last thing I remember.

the 2nd opinion

My fall was on a Thursday, and I saw a doctor the following Monday. I crutched into a back room where a woman removed my cast, and saved it on the back counter for later (they do that? It struck me as peculiar). There's no way I'll need surgery, I thought to myself. "I won't need surgery, right?" I posed to J, a question that was mostly rhetorical. He said probably not - the ER doctor said it was a fracture in my fibula and there was no displacement (whateverthefuck that means). The bone doctor eventually came in after having a look at my x-rays. "Well, you definitely need surgery" he said dryly. A little too dryly for my taste.

He listed the risks of not getting the surgery and scared me a lot - arthritis, the bone never healing at all, blah blah. Then he talked about a big nerve they'd be operating around that controlled my outer foot and that "we know where it is and we'll do our best to avoid it." He asked if I had any questions and I did not. I had no thoughts. Oh wait I had one thought: OMG, I'm on Grey's Anatomy.

Fuck you bone doctor. But ok whatever, I'll get your damn surgery. We scheduled it for 3 days later, a Thursday. The assistant then took my old cast, put it back around my leg, and proceeded to affix it back together with ace bandages. MOST PAINFUL. The days with that pieced together piece of shit were the worst of all - no circulation in my leg or foot and it caused major swelling and bruising. I wasn't thrilled with this doctor or his team.

But guess what I didn't know? People in the medical world get second opinions like women buy tampons: ALL THE DAMN TIME. With my family and their friends on board, they hooked me up with this other dude who specializes in ankles and I went in to see him on Wednesday - the day before my surgery with the lame doc. They took off my oppressive Nazi cast and had me do a CT scan which showed that the fracture was way more complicated than the x-ray had shown (thanks for nothing other doctor for not doing that, wtf). These guys knew more, they talked more, and I dropped the other dude like a bad habit - luckily these new folks fit me in for my original surgery date - the next day. My first surgery ever.

the day i broke my ankle

Not a lot is going into this blog. It's a way to keep anybody who cares updated, and also I can hopefully offer some insight into What to Expect When You Break Your Ankle. I broke my ankle on a shitty day in April, 2013 - I tripped getting out of a car, after having just moved to a new city. In retrospect should have started writing this on day 1, but I've had a pretty foggy brain up until this point, so I'll do my best to just play catch up.

 

After the fall (that happened somewhere between the curb and my aunt's car) I ripped my boot off immediately, trembling with the shock of the worst pain I've ever felt in my 29 years on this planet. I got right back into the back seat and tried to elevate, feeling as if every bone in my foot had popped out of place and was now swimming loosely inside my skin. In the ER they gave me ice, an x-ray, and a big shitty cast replete with paper pants (yes they cut my jeans off of me)...oh, and fucking crutches.


I was (am) in the very lucky position to have my boyfriend (with whom I live) and my family nearby, so I wasn't stressing too much about HOW I would actually be taken care of. A far cry from how I imagine I'd have felt given where I'd just moved from - NYC. I was sent home and told to take Tylenol, and they made an appointment with some bone doctor for the following week so my swelling could go down.

My boyfriend, let's call him J, eventually had to cut me out of these wretched paper pants - luckily I had these Old Navy lounge pants that are super wide legged and loose and comfy. I recommend them - they're also cheap.

I basically remember nothing more from this day - except that I really wanted strawberries.