New Ankle, New Year
Written on December 30, 2012 by Daniel P. Malito
By the time you read this, the ball will have dropped and the New Year will have officially started. As my faithful readers know, I did not post a blog entry last newsletter, and for that I truly apologize. In addition, because of the multiple postponements and delays that occurred with the right ankle replacement, the “ankle replacement blog” that I had planned to write also fell by the wayside. I have no excuse, and for all of this I throw myself on the mercy of the court. All I can do is relate the facts that I have been dealing with for the past month or so and let you make your own decision whether or not to lynch me.
I can say, without reservation, that the ankle replacement has been one of the most painful – no, actually, it is the most painful surgery I have ever had. It has been so bad, in fact, that I let the pain and the resulting pain medicine affect me enough to disappoint my readers. What makes it worse is that everyone I spoke with told me ahead of time that ankle replacement surgery is extremely painful. In fact, every time I mentioned it to any medical professional, they would invariably respond with something like “whew, that’s gonna be painful,” or “wow, that’s a tough one pain-wise.” As I often do, I brushed these warnings aside and just assumed I knew best. Unfortunately I was wrong. One surgery fellow put it best when, the day after the surgery, I asked how things looked. He said “it looks like it’s gonna hurt like a son-of-a-bitch.”
The surgery itself wasn’t too bad, believe it or not. It lasted almost six hours, but that was only because I had virtually no ankle left and the surgeon had to perform the procedure in two steps. He first had to replace the ankle and then he had to reconstruct the foot so that it fell flat when I walked. Previous to the replacement, my “ankle” was not really an ankle at all – it was a mass of fused bone that was holding my foot at a 45 degree angle to the floor. This forced my hip, my back, and my upper body off-kilter, which resulted in pain in several areas, and would eventually lead to joint damage. So, the blob had to go.
The surgery itself was a total technical success, and my surgeon himself said “we finally caught a break” when he met with Allison at the end of the procedure. It seems that my ankle had deformed in exactly the right way to support the ankle replacement hardware and the two staples my surgeon had used to straighten out the remaining foot bones. I only spent three days in the hospital, and was sent home with a cast on my foot and a walker in my hand.
The first two weeks at home were extremely difficult. The cast on my ankle was not weight-bearing, and because of this I had to quite literally hop everywhere on one foot. This might seem like a minor inconvenience, and probably is to an otherwise-healthy individual. For me, though, hopping on one foot was extremely hard on the knee. To make things even worse, my left leg (the one I had to hop on) was my non-dominant side. I had not used my left leg to ascend stairs, drive a car, or stand up in many years. Everything I did that required using my legs, I used my right side to do. This even included going up the stairs one at a time. Needless to say, my left side was weak, and now I had to use it to hop around everywhere like an amputee kangaroo.
I just want to interject here that these are the types of things that no one tells you. If any doctor had made it clear that I was going to have to hop around on my left leg after surgery, I would have strengthened the muscles on that side at physical therapy. This is a perfect example of one of the reasons I write this blog – to tell the undocumented tales about surgery and living with a crippling illness that no one else wants to or has the ability to tell. I truly hope that, in some small way at least, I am making things easier for some of you out there. Anyway, I digress – back to the story at hand.
So there I was, hopping around on a weak leg with a prosthetic hip that was prone to dislocation, waiting for the pain to subside. Fortunately, the discomfort I felt began to lessen after the first week, and when I went in for a hospital visit after the second week, the pain had become tolerable. On that visit, the cast I had received after the surgery was replaced with a weight-bearing hard cast. I was told that the surgery looked “fantastic,” and that I could put weight on the foot now. I was ecstatic to hear the good news – no more acting like a bunny rabbit for me!
When I got home the first thing I did was walk up the stairs myself and it felt great. Things were looking up – I was walking on my foot, the pain was almost gone, and the surgeon told me everything looked great. So I went to bed that night and was able to sleep like a baby for once. Unfortunately, when I woke up the next morning, the pain came back – with a vengeance.
All that next day and the three after that, my ankle hurt worse than it did the day after surgery. I’m not exaggerating either. It was so bad that I emailed the doctor to ask if this level of pain was normal or if something was amiss. He told me “yes it’s normal, especially with the amount of reconstruction you had done.” I knew now that it was normal, but I still wondered why my ankle started to hurt so much three weeks after the surgery. It was then that I realized some of the nerves that had been severed during the procedure were just now reconnecting, thus allowing the pain signals to travel unobstructed to my brain.
So, here I sit, a month after having my right ankle completely replaced by metal and plastic, with my right leg in a cast up to my knee, propped up and elevated to help alleviate the aching, while I swallow copious amounts of narcotics to attempt to lessen the excruciating pain long enough to sleep. Those of you who have had prosthesis installed know that there is no pain quite like the pain of a joint replacement – the deep seeded, lightning-strike speed, throbbing dull ache that smolders and feels like something vital deep inside you has been damaged. Pain medication can’t touch pain like that but if you take enough of it you will either fall asleep or the rest of you will feel good enough to let you forget about the tragedy playing out in one of your limbs. That narcotic pain medicine is so terribly inefficient is something that the medical community has been keeping under wraps for a long time now, mainly because there is no alternative – it’s Morphine-derivatives or nothing. I never thought I’d be in more pain now than I was the day after surgery — I should have listened when many people told me that this would come to pass.
So both the year and my ankle are new, and what a painful time it’s shaping up to be. 2013 will be a year of accomplishments, though, as I have so much planned for the coming months. Besides several projects I have my hands in, I plan to finally release my autobiography. I know many of you have been waiting to read it for a long time now, and I will ask you to be patient for just a little longer. We are still attempting to find an agent to help publish it, but, truth be told, soon we will begin the self-publishing preparations if an agent does not appear. As for my readers, you are still the best, most caring, greatest fans in the world – and thanks to all of you who e-mailed me with concern when my blog went un-posted last newsletter. You are the reason I write this blog, and don’t ever stop e-mailing, writing, calling, posting on Facebook, and Tweeting me, ever. Happy New Year!