Tag: broken bone

Ankle exercises

Am in week 4 of my 6 weeks of non-weight-bearing. Am not in a cast anymore, but can’t put weight on it for 2 more weeks. Doc has advised to exercise the ankle 4 times a day… just move it around in circles and up and down. Try to get better range of motion.

The problem is, my ankle is so stiff that it feels like the bones are fused together. I can point my toes downwards, but I can’t point them towards my head. My foot doesn’t move backwards beyond a point (90 degrees). And my other good foot does , so its quite disheartening to see the difference and know how much the bad foot needs to catch up.

So I’ve figured that its the muscles and tendons that are really stiff, particularly the area above the back of my heel (achilles). There’s no way it will stretch unless the tendon or muscles get loosened up.

Enter Contrast therapy/Alternate heat-cold therapy. Athletes use this to recover from injuries faster. Basically you do this:

1. You heat the area for 10 min using a heat pack or hot towel. During this time stretch the tendons out as much as you can. You can use a towel around your foot and pull the ends towards you with your hands. Heat relaxes muscles and increases flexibility and range of motion. There is also less pain while stretching… yay!

2. Immediately follow with an icepack on the same area for 5 min. Continue to keep your foot stretched. This kind of freezes the tendon into its stretched mode.

3. Repeat procedure next day. You can continue the alternate hot-cold a couple of times in the session, but if you’ve had surgery like me, your ankle will protest. Slow and steady.

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TIPS:

Do not use overly hot or cold packs. Keep a cloth between the pack and skin to prevent burns/frostbite

Do not use on stitches/open wounds. Don’t use heat on swollen areas.

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Watch this video to know how to do it right –

Depression

Some days you just don’t feel like waking up. In any case you can’t get up and stand, let alone walk. What’s the point? Each day is a struggle and really, it feels like you’re going nowhere. Everyone is going on with their lives, while you are stuck in your bed, in your room, hobbling around on crutches. 6 weeks of non-weight-bearing is the longest 6 weeks of your life.

Breaking your ankle means losing all your independence. Someone has to wait on you hand and foot (pun intended). You have to be driven to the doctor, someone cooks for you, its a big achievement just to be able to shower and change by yourself.

You miss out on birthdays. You miss people’s weddings. You miss normal life, like being able to walk around the house, drive to the supermarket, go for a movie. Yes, you will be able to do all these things again, but right now, now you can’t. And it sucks. I’ve had to cancel upcoming trips… hotels and flights and concert tickets that I had booked before my ankle broke. That SERIOUSLY sucks.

More than coping physically, its tougher coping mentally. Even with all the books you can read and all the TV shows you can watch, you are so bored and depressed that you don’t want to do anything. You just lose the drive, the motivation for life. Because after the 6 weeks of NWB (non-weight-bearing), there will be another painful month of physical therapy. It takes about 3 months to get back to normal, sometimes longer, depending on the severity of your fracture. Right now I am in week 3 of NWB. Its a loooong road ahead.

Some days the depression gets the better of me. Some days I’m grumpy and snap at everyone. Some days I just cry. Some days I laugh hysterically. Some days I’m angry with God for putting me through this. How does one deal with it? I don’t have the answer.

This is what I know… It helps to have people come over. For an hour, you almost forget that your ankle is broken. It helps to eat your favourite food and watch comedy shows. Music helps lighten your mood. Big bear hugs from loved ones really help. It helps to try and learn something new… the internet is full of free tutorials on every thing imaginable. It helps if someone takes you out, for coffee or a meal, if you can handle it. Because honestly, sometimes you just need a change of scene. After a while your room feels like a prison cell.

Its been the most trying period of my life. Patience is not something I have a lot of. Reading other people’s ‘broken bone’ blogs, I’ve figured that its normal to feel frustrated. Everyone with a long recovery period has gone through it.

I started writing this blog just to give myself something to do, and to let all my feelings and frustration out. Stats show that people are actually visiting and reading my blog, and thats quite exciting 🙂

How to remove scabs without leaving scars

If you are a guy, scars are cool. If you are a girl, this post is for you.

After taking my stitches out, I was left with a bunch of scabs around the wound.

Much googling and experimenting later, I have come to the conclusion that this is the best way of removing scabs.

NOTE: this is for old scabs. My scabs were two weeks old and almost ready to come off. Do not pick at new scabs.

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What you need: hot water, cotton, gauze, petroleum jelly, tape for dressing.

STEP 1: Wash your hands thoroughly with soap and water.

STEP 2: Ask someone to boil water and give it to you. Put a lid on it so it doesn’t cool.

STEP 3: If you have many scabs, its better to tackle each one separately. Start with the smaller ones first. Dip a small piece of gauze or cotton into the hot water. Press it against the scab (make sure it isn’t so hot that you burn yourself). Continue to wet the cotton if it cools down and hold it against the scab for a total of 2-3 min. This makes the scab and the skin around it soften.

STEP 4: Use gauze to rub around the scab. Rub up and down and left and right. Or place your finger on top of the gauze and twist around in a circular motion. The scab should come off painlessly.

STEP 5: Repeat hot water and rubbing procedure with each new scab. If Its not ready to come off, leave it and and try again the next day.

STEP 6: By now some scabs will have come off, but the bigger, more stubborn ones will still be there. Coat all the scabs liberally in petroleum jelly (the plain non-scented type). Cover with gauze dressing and tape it. Leave it on overnight. This keeps the scab moist.

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Repeat the procedure every day till all the scabs come off. Petroleum jelly at night… hot water soak and scrub in the morning.

I had about 14 scabs and it took me a week to get all off. The biggest one came off last.

Patience, and persistence.

Nutrition: Foods that speed up fracture healing

Google has a lot of information on food that is good for your bones, ie. helping fractures heal quicker.

Even though you are mostly sitting around, your body is in high gear and burning a lot of calories while trying to repair itself. So you need to supply your body with enough fuel for it to do a good job.

First I will give you my menu, followed by and explanation of why each food is important and what nutrients it gives you.

(Reference – I am female, age 33, weigh about 50 kgs. Adjust portions according to your requirements)

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MORNING

coconut water – (potassium)

one apple plus any other fruit – (vitamins)

2 scrambled eggs on toast (2 whites with one yolk), chicken salami/ chicken sausages – (proteins, carbs)

one glass low fat or skimmed milk – (calcium)

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AFTERNOON

one glass freshly squeezed orange juice – (vitamin C)

Fresh salad – tomatoes, lettuce, sprouts, olives, feta, dressing  – (vitamins)

quinoa or rice with other veggies like peas/ carrots/ potato – (vitamin A, carbs)

any protein – chicken/ fish/ soya/ cottage cheese/ lentils/ chick peas – (proteins)

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SNACKS

banana yogurt smoothie – (potassium, vitamins, calcium)

muesli/ oatmeal/ granola bar/ peanut butter sandwich – (protein)

seeds – pumpkin/ flax/ sunflower – (vitamins, minerals like magnesium, zinc)

dried fruits – almonds/ cashewnuts/ walnuts – (vitamins)

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EVENING

soup: stock made from boiling chicken bones is great – (minerals)

green leafy veggies – spinach/ broccoli/ beans/ cabbage – (vitamin K)

bread or roti with other veggies like peas/ carrots/ potato – (vitamin A, carbs)

any protein – chicken/ fish/ soya/ cottage cheese/ lentils/ chick peas

dessert – icecream or yoghurt with fresh fruits

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FOODS THAT ARE BAD FOR BONE GROWTH:

1. Salt

2. Sugar

3. Alcohol

4. Caffeine (this includes soft drinks like coca-cola)

5. Smoking

It’s difficult to give up salt and sugar altogether, but try to cut it down.

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TIP: Also, try to sit in the sun for a while everyday! Vitamin D helps bones absorb calcium.

Tips on using crutches

CORRECT ADJUSTMENT

– Crutches should not be exact armpit height, they should be one or two inches lower than your armpit when you are standing straight on one leg.

– Adjust the hand grip to be level with your hip. Your arm should be slightly bent when your hand is holding the middle part.

– Do not lean on the top part of the crutches with your armpits. Put the weight on your hands and use your upper arm to hold the top part of the crutch close to your sides.

STAIRS

Going down: Put both your crutches on the lower step. Bend your knee and bring your good leg down between the crutches. For every step going down, crutches first and then the good leg.

Alternate method: This is only possible if is there is a railing on the side of the staircase. Hold one crutch on the bad side. Hold the railing with one hand. Crutch first on the lower step, follow with the good leg. Continue to hold the guard rail and repeat.

Going up: This is the other way. Keep your crutches on the lower step. Put your good leg on the step above. In one move, straighten your good leg to stand on the upper step, while bringing both crutches up as well to either side of your leg. There may be a slight wobble when you are stepping up, but bringing the crutches up quickly will support you.

Alternate method: This is only possible if is there is a railing on the side of the staircase. Hold one crutch on the bad side. Hold the railing with one hand. Put your good leg on the step above. Straighten your good leg to stand on the upper step, while bringing the crutch up on the other side.

SITTING AND STANDING

This is pretty unsteady on crutches. Use one arm to push yourself upwards from a sitting position while holding crutches in one hand. Balance on one leg while putting crutch under each arm. When lowering yourself down, let go of one crutch and put a hand on the seat or armrest first.

GOING OUTSIDE

Use a fanny pack to keep your phone, wallet and keys. Position it in the front of your body, not side or rear.

Refer to this post for pictures – http://www.wikihow.com/Use-Crutches

How to shower or bathe with a cast

Obviously, your cast or plaster is not supposed to get wet.

After many unsuccessful attempts, I have concluded that double bagging is the way to go.

STEP 1: Take your pyjamas off! Once you have put two bags over your foot, its very difficult to remove clothing over it. Common sense, yes, but I have made this mistake.

STEP 2: Take a kitchen garbage bag and tape it to your leg using 2-3 inch width plastic transparent masking tape (Do not use paper tape, this gets wet and soggy). Tape it around 2-3 times to make sure water won’t go in. Squeeze the extra air out of the bag before taping, to avoid having a balloon attached to your leg. Fold the tape over to make a tab on the end of the tape before sticking it down, this makes it easier to remove so you don’t spend 5 minutes trying to get it off.

STEP 3: Over this put another, thicker plastic bag (I use the amazon plastic bags that come when you order books online). Squeeze the air out around your leg, tape around it with the same tape, 3 times around your leg. Make a tab for this too.

OTHER TIPS:

– If you have a shower, buy a knee-height plastic stool and keep it in there. It’s a lot easier sitting down.

– After showering, I sit on the toilet seat lid to dry and dress myself. Use a hand towel to cover the lid to protect from germs. Also, if you are wet from after the shower, you tend to slide off the seat, so the towel prevents that.

– Going to the bathroom on crutches is really difficult! For inside the house, a walker is easier than crutches. A walker doubles up as a hanger for clothes and towels when you are bathing.

– For brushing your teeth, either do it in the shower while you are sitting down, or use a chair near the sink. Place the chair with the back facing the sink and kneel on the seat. If its a chair with a cushioned seat, like a dining chair, this is the most comfortable.

– Computer chairs with wheels are good for scooting around the house! Like a wheelchair but not as bulky.

Types of Pain

So I’ve categorised pain into different types following my ankle surgery. It may help when you need to describe to your doctor.

1. Bone Pain (intensity: 9 on a scale of 10)

The only reason I haven’t give it a 10 is because I’ve reserved that for multiple bone fractures, or amputation. I describe this as wanting to cut off your own foot and throw it away, the pain is that bad. Bone pain comes suddenly, sharply, you feel it deep in the middle of your bones, for me it would only stay a few minutes but strike a few times a day and leave me sobbing. Apparently its your body trying to reject the nails and screws and foreign bodies in there.

2. Cast Pain (intensity: 8 on a scale of 10)

If your cast is fit properly, this should not happen to you, but if your foot swells after they put the cast on, its crazy painful. The hard plaster-of-paris cast was cutting into my bone and putting way too much pressure on the already painful incision area. I cried and screamed until the doctors physically cut the cast off my leg. Then they put on a lighter, better fitting cast. TIP – Fibreglass casts are lighter.

3. Surgery Pain (intensity: 7 on a scale of 10)

This is the area where they made the incision and stitched it up. It is a flesh wound, but pretty deep so you still feel localised pain around the ankle. This being a flesh wound is a familiar sort of pain, unlike bone pain which was something completely new for me, and something no one should ever experience.

4. Removing stitches (intensity: 6 on a scale of 10)

They will tell you it doesn’t hurt. It does. This is 10-12 days after the surgery.

5. General pain (intensity: ranges from 3-5 on a scale of 10)

This is a dull ache of the entire foot. This stays all the time, 24-7 for the first week after surgery. Painkillers do nothing for it.

It has now been 17 days since my surgery and the pain is at a 2.

It gets better.

Slowly.

Flying with a broken ankle

The fracture happened in Bali, Indonesia. I live in Mumbai, India. Which meant that I had to fly back home with a broken ankle.

Complication #1 – You cannot fly in a full cast. Problems with circulation and swelling. Most airlines will make you cut or split the cast open before flying.

Solution – The doctor put a backslab. Its sort of a half cast made of fibreglass that covers the sole of your foot and goes up the back of the leg, like an L shape. They tied an elastocrepe bandage over the backslab to keep it in place. This keeps the ankle immobilised and ensures that if your leg swells you can untie the bandage.

Complication #2 – Swollen legs while flying can give you blood clots or DVT (Deep Vein Thrombosis). DVT can be fatal.

Solution – The doctor gave me a blood thinner injection called Lovenox (works for 24 hours). This makes the blood thinner so that clots will not form.

Complication #3 – Airline requires a whole lot of paperwork to clear you for flying. You will need a doctors report that declares you ‘fit to fly’ and this has to be scanned and sent to the airline, which will go to headquarters and get cleared by the airline doctor.

Solution – All this takes 1-2 days to process, so start the prep in advance. Call the airline office and mail them all the necessary documents.

Complication #4 – Leg has to be kept elevated 90% of the time while flying

Solution – Business class was too expensive and the airline (Malaysian Airlines) refused to upgrade me to business even with a broken ankle. So next best is to sit in the first row of economy class (the ones that are reserved for moms with babies). There is more legspace, you can stretch out your leg and prop a suitcase under it.

Tip – Ask for a wheelchair in the airport. You skip most queues, get wheeled straight onto the plane and off it, all the way out. Otherwise its way too much walking on crutches.