Ah, the end of the month … it means that in two weeks it would be the fourth month since I broke my bones and third month since I started my physical rehabilitation treatments.
My bones had set well and good. I was already given a full-weight bearing go signal by my doctor, and my therapist had been wearing me out trying to work more on my gait quality and endurance. Strength is not a problem for me, but I still have residual tightness and numbness which as I was told is usual with ankle injuries.
Although, my therapists been telling me that I recover fast and is able to do active exercises faster than most patients they see in similar condition. And my doctor also said the same and mentioned that some patients love their injuries so much they don’t want to be moving on their own, I am the opposite.
I challenged the norm pushing myself hard before it’s time, and it fought back putting me in my place by letting me feel pain.
The weather in the Philippines been rising. I was still happy until the summer officially kicked in because the heat is also kicking us all indoors.
My doctor was right when he said “let’s not put you on full leg cast” when he saw me the first time in January. Instead, he prescribed for me to use an Air Cast, a type of boots that I put on myself with help at first, and adjust the pressure on both sides to control the movement of the ankle as I start putting weight on my foot while keeping the ankle secured and stable.
He said I will thank him come March knowing that the temperature will continue to rise, and I am thankful indeed. Since 4 weeks, after wearing the boots at least 12 hours per day, I am almost not wearing it at all. I walk around the compound in shorts, without an appendage and only has one when I go to the hospital or attend a meeting like I did last week.
Wearing the boots outdoors now is more a precaution and protection from bumps in high traffic area like hospitals and malls. Otherwise, I almost don’t need it anymore, soon it will have to be shelved until I need it when my wires are removed.
** In spite of the positive remarks from my treatment team, I still feel I am not doing enough, and I still feel sad and depressed sometimes with my condition. That was one of the reasons I had by set-back that I wrote all about here Happy Scar, trying hard to fast track my recovery that I almost re-injured myself, at least in my mind. I am counting the days within the time frame I set for myself which is by mid-June to see if my physical and emotional self will be attuned. For the meantime, I am trying to fight off the heat playing in the garden with my niece and the garden hose.
The words my doctor, let’s call him Dr. G, told me praising my perfectly healed surgical wounds. According to him because he took my crazy stitches out early, the wound healed according to how he wants it. Since he didn’t do my surgery, it was done in another place by another doctor; he had no control how my wounds were closed. That was the best he could do so I don’t end up with ugly scars.
Just so you know …
The one I showed you in the Happy Scar post is found on the inner side of my ankle. I had pins and wires inside used to attach my bones, and I have a smiling scar to remind me of that. The other one is on the outer side of my leg; it’s as straight as it could be. My therapist even said it looks like a vein only it is outside. I had a metal plate inside to attach them securely and take up some of the load when I started putting weight on my leg. I plan to have it tattooed with leaves and sunflower to match my smiley one.
I arrived home one week after I had my surgery in Tunisia. The doctors there did a wonderful job of fixing my bones and closing my wound with very tight stitches according to Dr. G.
I had extra wounds too, but they didn’t need stitching and again not necessary according to Dr. G. Those extra wounds were from the drain tubes they attached and kept for several days after the surgery, that’s why I had the dimples in my smiley scar.
So after I was seen by Dr. G, in the emergency room two days after I arrived from my 24-hour journey, he declared he would take out my stitches in one week or two the most to promote faster healing and for me to end up with nice looking scars.
Two weeks later, I am out of it, and with little TLC, the wound finally closed, the last dead skin fell off, and I am left with shiny new scars — my new battle marks!
I am not new to accidents while away for work. I guess it’s part of the deal when you accept to live alone and do everything yourself. But most of my accidents were injuries from the kitchen — nothing traumatic and obviously not life-threatening. Like when one time I was baking and the hot baking dish landed on my thigh, and I developed an unsightly and very painful second-degree burn. Or when I accidentally cut off the top part of my nail because I was pretending, I can do what professional chefs do when cutting onions. I thought I lost part of my finger when I saw the blood. Good thing the nail grew back.
Whatever happen scar doesn’t just appear. All wounds heal if we take care of it and it can leave a beautiful mark. But if we don’t, it will fester until it gets out of control, it will leave an ugly mark.
Whatever mark was left, it is there because something significant happened, a mark giving us a choice to not do it again or to continue to be strong. It is there as a reminder that we are vulnerable, that anything can happen and we will have something to show for it.
Well, my doctor gave me more thumbs up.👍👍👍👍👍👌 It means my bones have completely healed and I graduated from partial weight to full weight bearing when standing, walking and even climbing stairs. It was a natural high, I was elated until I crawled back under the rock and stopped doing exercises at home.
While my physical healing is improving every day, my emotions are like a roller coaster. Most of the time I stay at the base than up there looking at the blue skies and happily shouting coming down.
I am still trying to figure out why I am having delayed psychological reaction to my accident … maybe it’s not even delayed, it is just manifesting now. I have no answers yet.
When I do I will let you in my discoveries … watch out!
For the meantime, I am taking advantage of the high and blogging and taking a cue from my smiley scar.
I’m at my ortho doctor’s clinic waiting for him to arrive for my first appointment and maybe my last during this month – the fourth month since my accident.
I came home after I was released by my attending orthopaedic doctor from La Marsa private hospital. I stayed a week after my surgery. And anticipating my need for full time care my organisation, and I decided to evacuate me back here. One week after being hospitalised I was cleared to travel with so much precaution, and class except I cannot enjoy the perks of a business class traveller when you’re nursing a cast leg and in blood thinners especially if your airline has good wine selections 🍾🍷🍹
So arriving after travelling 10,000 kilometres for 24 hours the reality of being disabled was sinking in. The local representatives of my insurance were in my case and scheduled me at the end of the week for a consult. The paranoid in me felt that I need to see the doctor immediately. Complaining of pain and thinking that my toes were turning blue. So instead of Saturday, I went to the emergency room three days prior only to be told my blood circulation was healthy and my pain was nothing to be worried about. My doctor just looked at my leg inspected the sutures and gush at how meticulously it was done and prescribed iron supplement and removed theblood thinner drugs. Then I was sent home. Uneventful 😄.
From then to now I wonder what will be the news … I am feeling lucky at my 7th visit to my doctor … that is if he arrives.
Entering the fourth month of my recovery means that I am almost there. In fact, according to the textbook, I am past the 3-month bone healing process, I should be on my way to walking independently until fully recovered
My last radiographic imaging showed that my bones were healing well. They were aligned perfectly, and my doctor gave me very positive commendation on how much progress I am making. He might just see me once a month instead of two, and that is a good sign, right?
When I say fully recovered means, more flexibility in my left ankle and no more swelling. But I still have both, and yesterday when I attended my therapy session it made me appreciate more the small changes I observed in me.
In the last months, I suffered what you will call “psychological breakdown.” Nothing serious where I need to seek professional help, I guess living with my family helps breaks my downward plunge but then if I am alone I am not able to do anything productive except maybe read a lot of books and start this blog.
It happened when I thought I made a mistake in my attempt to recover early. I told you I am my own worst patient, and I didn’t follow my own prescription and pushed myself too much. When I was not entirely satisfied with my therapy sessions, not getting good results, I increased my home treatment.
One day I started to feel pain when stepping on my left foot and attempted walking. I thought I was just tired and iced it. It didn’t improve with ice and rest, and even when I put on my aircast, I still felt pain when I put my foot down. Got more worried when I was not able to do proper gait training during my therapy session because of illness. I reported to my doctor, anticipating I made my situation worse and all knowledge and reasons I know are thrown out of the window!
No, it was brought on by me still walking on partial weight-bearing, and my forefoot and longitudinal arch are tight. All my doctor did was stretch it, it was painful, but it helped as if I didn’t have pain after all.
With that painful episode, it became a trigger for me to be getting down and worried, thinking about how pathetic my life is and replaying how I came to be in this situation. I noticed a trigger … the thought of work, of some name or words related to my life before the accident triggered these melancholic episodes that made me dive in and swim in “self-pity.” I wrote about it in my other blog Bouts of frustrations, boredom and a little bit of self-pity
So what now?
I am trying to crawl back out. To get back into looking at what I needed to do and finish what needs to be done soon.
My spirit actually lifted because of 4 degrees increased in my dorsiflexion. It means that I have 6 more degrees to go to reach the full range of 20. That motivates me to be more positive and do more careful exercises at home not that I also decreased my therapy sessions. I am trying again to be the good patient as I could be.
Additionally, I decided its time to be functionally independent in self-care. It means I am doing it alone overcoming the fear of slipping again and planning on my new shower routine without breaking my bones. That’s for another blog.😉
I am living for six days in my new house in Sidi Bou Said in Tunisia few days after the new year when the accident happened. The house that I fought to get because the people that were supposed to help me settle in my new country didn’t actually help. The moment I saw the house it was for me, I felt at home immediately even if I know I will only stay for two short months working remotely for my work in Turkey.
It was also not a hard decision to make because the house and its owners speak for itself. The owners are good people, and with my accident, they’ve proven to be angels in disguise.
As I settle in that first week, I slowly develop my daily morning routine – waking up at the crack of dawn, take showers and get the coffee running. To be followed by simple breakfast of bread and jam and more coffee. Then I set up my workstation in the smallish dining area, roughly around mid-morning, the time my work country is also starting their day. In the afternoon, I would go out to walk around the small town, get something to eat or simply watch the people as they come back from the city center.
On the 6th day, I woke up earlier than usual and cannot go back to sleep, so I decided to just take a shower and catch up on work earlier than usual.
I didn’t do anything different, including stepping on the rubber mat that was in front of my shower box since day one but for some reason, the mat slipped under my feet, and I found myself sitting on the bathroom floor with my legs in two separate places … the right leg was in front of me while the left leg was inside the shower box. The moment I looked at my feet, I knew something was wrong, I felt no pain, but I was pretty sure my ankle was dislocated. I saw my left foot slightly off further to the left, away from my leg bones compared to my right leg.
I was jolted awake because as if I was sleepwalking when it happened. It took me a couple of minutes to get my thoughts in order and my bearing to get dressed again before I called for help. Luckily there’s a grab bar next to the door; it helped me get back up, balancing on my right leg avoiding weight bearing on the left side.
I started hopping to my bedroom, holding on the wall to secure myself until I retrieved my phone. Reaching my room and my bed, I crawled to the other side close to the window. And propped myself on the French window, leaning my back on the wall while I raised my leg – thank God for pillows! Called the only friend I have (at the moment), who happens to be the logistics coordinator of the Libya mission whom I knew would be also up and getting ready for work and said “I need help, I had an accident, bring me to the hospital please,”
I called my landlord right after, and in short time the couple was in my house fussing around me genuinely concerned making me feel comfortable while we wait for the car.
I am not a superstitious person, but I believe that sometimes the world has a way of telling us the future.
Days after I arrived in Tunisia I started inquiring about logistics condition for expatriates, the information that should be readily available to share with anyone visiting the county particular on police and hospitals. As bureaucracy would have it, I didn’t get that information and then the accident happened.
My friend E also doesn’t know where we should go in an emergency situation, the information was provided by my landlord. Fifteen minutes tops we were at the emergency room of the only private hospital in the area known to the diplomatic and expatriate community (but not to my organization – efficient!). It offered quality services, I could attest to it with the services I received the week I stayed there before I was evacuated to the Philippines.
But then, when I think of it now, I may have had a premonition that I will be needing medical services and eventually I did. I don’t know what could have happened had I not asked for that information in the first place. But then again, premonition or not accidents do happen, and I attributed this one to be just that, an accident.
More than dislocation …
Forty-five minutes after the accident, as I scooted down my house and hoped to the car, I waited another hour to get confirmation of my predicament.
While I wait for the results of my x-ray, and my friend and landlord were preparing to find me a room, my ankle starts to swell. It could have been worse if I didn’t apply my knowledge of acute trauma management.
The moment of truth arrived, after waiting for almost an hour since I arrived in the emergency room — my ankle was not only dislocated but by leg bones are broken. It was explained to me with by the nurse in broken English because I neither speak Arabic nor French and them English, but the x-ray plate says it all regardless of my background.
For those who care to know — the fibula which is the smaller non-weight bearing bone of the leg and the tibia which forms part of the ankle joint, the main weight-bearing joint is broken.
I was shaken a bit because I was still hoping until I saw the x-ray that they would just have to reset my ankle, and I will be in a cast and be on my way but no, the breaks are big and I will need surgery to fix it.
I had no choice, but to accept my situation. It was not a difficult decision to make, I will need the surgery whether I like it or not but I was worried I was alone in a foreign land. All sorts of thoughts run through my head, but I was assured by my landlord that they will not leave me alone — they officially announced in the hospital that I am their adopted daughter. They assured me too that the doctor that would handle my case is a renowned specialist known in the country (even a little bit of a celebrity).
Late in the afternoon, I was out of the operating room like nothing happened. I was awake during the 2-hour surgery, didn’t feel any pain but was very thirsty. When they transferred me to my room, ( was happy to see my adoptive patents waiting for me as if I was indeed one of their own children.