Days go on....

I've had some problems accessing my blog! I'm not sure why - but for the last couple of days - I haven't been able to post. :-(

Been raining since Sunday and whether the weather has anything to do with it or not - today was a very painful day with my ankle.

Even though it is spring break (for my high schooler), I had to wake up early today to go help out at the church for the kalacs (nut roll) sale. I am a roller. As I was feeding our companion birds this morning before I left for the church, it felt as if something just shifted from the inside to the outside - and it hurt like the dickens!

While I was rolling dough, I'd periodically have to just take all weight off the foot/ankle so it wouldn't hurt so bad....

And its been on and off all day like that...actually - since Sunday - but today has been the worst. When it hasn't hurt - it's been joyous - but when the pain raised its nasty head - whoa boy!!!!

Today's pain level.....where 1 is minimal to none and 10 is the worst pain ever...
6-7


Some of the kalacs' that we made this morning....

MRI

So - the surgeon referred me for an MRI. The first hospital that I was referred to couldn't get me in until the end of June (and by then I am hoping to be healed and on my road to recovery). I called a second hospital and they were able to get me in yesterday - so I jumped at the appointment.

Everyone at the hospital was nice and cordial. They did everything in their power to make me comfortable and happy.

The tech who did my MRI was wonderful. He explained things to me and answered all my questions. He warned about the noise and handed me headphones with "background music". I put them on and it was a "soft music" station - but they were playing some stuff with a good beat. Kind of hard not to be tapping my toes to the beat. ;-)

So this was my first ever MRI. I savored the entire experience.

I had to jump up on the table and place my right foot and ankle into this contraption that was similar to the bottom half of a foot/leg cast. The foot had to be flexed so that the tendons could be seen more clearly. (This was painful in and of itself - flexion for an extended period....) Once I was in this contraption, the tech placed the other half of the foot portion of the "cast" over my toes and lower arch, and then another piece over the lower leg. He told me not to move - and I seriously doubt I could have moved my foot/ankle even if I wanted to. The uninjured, free leg was simply laying next to the whole contraption.

I laid down with the headphones and was slid into the machine. Since it was an MRI of the ankle, I was in to about the "empire" line (for those that don't understand that - just below my breasts).

I was fascinated by this whole process. The machine showed when the radio waves were being emitted by flashing a little "lightening bolt" on one side. The count-down clock was ticking on the other side and I could follow it for the length of time each particular wave set was going. Two minutes, three minutes...repeated over and with different sounds for each group. (I asked about the different sounds and the tech did say that there were different radio frequencies so that's what I was probably aware of). If I didn't have my contact lenses in, I probably would have snoozed off during this whole thing! :-D

I was really good through out until the last four minute "blast". Whatever that particular frequency was, it was uncomfortable on my ankle. While not painful enough to make me cry or cry out - it was enough pain to make me wince and it lasted through much of that four minute barrage of waves. The tech was surprised I "felt" it - but said it does happen on occasion.

Afterward, I got copies of both the films and the disk with all the shots of my ankle. Of course I looked at them, but I have no idea exactly what I'm looking for - so it was an exercise in futility.

The ankle felt no better - no worse - after this test. It still hurts and I know it will until the surgery.

Stopping at church for the fish fry later that evening - the minister was asking me about the ankle. When I told him I was definitely having surgery - he seemed saddened and concerned. I told him in my happiest voice that I was THRILLED to be having the surgery - because it was going to FIX the problem and I was not going to be hurting all the time any more. (Of course I know there will be pain during the healing and recovery process - but that is different than this pain.)

As soon as people start realizing that I'm happy to be getting this done and stop this kind of pain and limitations on my daily life - I will be a much happier camper.

Pain index - 1-no pain and 10-worst pain ever....
Pain index for Friday - probably 4-5
Pain index for Saturday - about 3-4 so far.....

Busy days

My intention in starting this blog was to do a daily update of how it feels to have an OCD lesion and how it feels to have it fixed. This week has gotten away from me so that I haven't been able to do a daily update. I'll try harder in the days to come....

Monday I saw the surgeon. When I got home, I started calling for the MRI appointment. This was pretty much an exercise in futility. The local hospital where I was supposed to have it done - couldn't get me in for the MRI until the end of June! As I told the appointment setter - I hope to be out of my cast and walking by then.

Tuesday, my youngest daughter had a doctor's appointment. We use the same family practice facility. While she was finishing up her exam, I went to the nurse with my release for surgery from the surgeon's office. Now I had just seen my primary doc the week before for a full physical - so imagine my surprise when the nurse tells me that I need to make ANOTHER appointment, have an EKG and get my blood work done before they will sign off on the surgery! Come home Tuesday and schedule the blood work (which is shortly). Got a call from the surgeon's office with a number to call to change the facility for the MRI. Called and after several calls to facilities - I have an appointment for tomorrow!

Tuesday night, that same youngest daughter cracked her ring finger at winter guard practice, so Wednesday - after my optometrist appointment, I had to take her BACK to the primary doc to be evaluated for a broken finger, then to the hospital for x-rays.

It's been a week so far of run, run, doctor, doctor!

Today is my blood work. Tomorrow is my MRI and a follow-up visit for the daughter.

Pain in my ankle? Of course - and its bad. I'm also periodically now getting pain on the outside of the ankle (the OCD is on the inside) - so this scares me that there is more going on in that joint than we first thought. I'm hoping the MRI would show that....

We'll see.

Now - I'm off to the blood-suckers!

Yes! We have a surgery!!!!!

So - here we are - no more history - in the here and now...

Today I saw the new surgeon for the first time. I actually liked him. He is a specialist in ankle and foot issues.

He apologized when he came in, for taking time to get to me, but he said he was reviewing my CT scan films and the x-rays I had brought along. After taking a brief medical history, he examined my ankle - actually, BOTH ankles.

Does this hurt, does that hurt, can you feel this, can you feel that...

I can feel you, ah - that's a sweet spot....that's ok - aye - now that hurts....

He took me in the hall and slowly took the time to rotate the images from the CT scan and show me exactly where the lesion was/is. He pointed out on the x-ray precisely what we were looking at....

Back in the room, I'm told - you've had this now for two years, and its not gotten better - you are a good candidate for surgery. (Did I want to hug this man or what????) He explained he would like me to have an MRI so he would have a better idea of what he's looking at. I told him my time concerns and that I'd like to have the surgery done as soon as possible after guard championships.

His response was that going to championships with the kids was more important than surgery....(Did I want to kiss this man or what?????)

He also said that given that time frame, there was certainly time to get the MRI done as well. So I'm good with that. His office called me shortly after I got home with the approval code for the MRI...sadly, the hospital where I was to have it doesn't have an appointment until the end of JUNE!!!! Now I need another pre-cert....

Microfracture surgery is most likely what we will do, perhaps repair the cartilage or maybe even drill - this will depend on what he sees in the MRI and when he finally gets in there. It may be done arthroscopically - but he did warn it might be open - again, depending on what the findings are...

He feels if I have the surgery in April, I should be good to go for marching season and definitely good to go for my own season in November....

Had problems finding where to put the ankle/foot last night to sleep...finally fell asleep from exhaustion, but woke while it was still dark to throbbing....after he prodded and poked - it throbbed...it is swollen....

BUT I'M GETTING FIXED!!!!!!!

Oops - maybe I should re-phrase that?????

History - Part 5

So - in August (over a year after the initial injury) I went for yet again another set of x-rays. Took them back to my primary doc and viola! an OCD lesion was confirmed!!!

Seems that actually, the OCD lesion was noted by the radiologist back a year earlier (9/08) but that the clinic docs never chose to tell me, or do anything about it. I guess in their defense, I have had two orthopedic surgeons tell me that "sometimes" OCD lesions resolve "on their own" - so waiting it out is not inappropriate.

I went to see an orthopedic surgeon in late October. He looked at the x-rays and we talked about the injury. He wanted me to have a CT scan to get more information on it all. So - that's what I did.

In November, I had a CT scan of the ankle and took the results back to the surgeon. Apparently, what he saw in the scan was significant and he wanted to send me to NYC for the "top doc" to do the surgery as he no longer did surgeries. I asked him about someone more local (NYC is 30 miles away - a daily commute for a lot of people around here - but I didn't think I wanted to ride home on the commuter train after surgery and I really had no one to take me there). He was very supportive and said he would write letters on my behalf to the insurance for an out of network doc to do the surgery if I needed it.

I called another surgeon and his office never got back to me.

With the holiday rush and the start of my coaching season, time got away from me and before I knew it, the new year was upon us....and with it, a letter from my insurance carrier that they were no longer doing Family Care and I needed to select another HMO....thankfully, I didn't have to start the whole process all over.

Once I chose a new HMO and got my cards and provider list, I was able to find two seeming adequate to good orthopedic surgeons. I contacted my primary (who was in the new plan - so yippee!!) and while he didn't know either practice, he agreed with my gut feeling about who to go with.

A full physical with my primary last week and his wishes for success with my ankle - brings us finished with the history lesson and ready to move at present day.

Since this has started (the ankle, not the blog) there have been good days, ok days and really miserable days. This past weekend was a pretty ankle miserable weekend - as was the week and weekend before and before that as well....

The pain and the swelling seem to be my constant companions. There are more nights than not when I can't even find a comfortable place to lay my foot/ankle and sleep is difficult to come by....anymore now, I don't even have to be doing much of anything vigorous....last weekend at guard com petition, I stepped onto the floor to help the kids get their equipment off and almost went down because the pain was so sharp and so intense. I was almost in tears and the kids all saw and were concerned.

But - I push through. Its like at church when someone asks why I still wear heels - my ankle hurts whether I'm in heels or in flats, in shoes or barefoot...if its going to hurt anyway, I might was well look good while I'm in pain....same with walking - it hurts to walk, but it also hurts when I don't walk - so I might as well do something positive...nothing is to be gained by sitting and moping about it...no one will give me sympathy...so grin and bear it is what I do....

History - Part 4

With plans to start a new marching season, I started planning for fund raisers for the color guard. We were lucky and the local Wal-Mart gave us every weekend in July to tag at their doors so the girls could raise much needed money for the program. As Guard Mom I chaperoned most of these tagging sessions.

I would come home from standing for six hours and my ankle would be swollen and sore. Now even more nagging than it had been. It was also starting to get shooting pains out of no where. I'd walk in the local grocery store and suddenly the pain in my ankle would be so severe, I'd be in tears and other shoppers would just look at me and wonder what was wrong.

I finally had it - now over a year since the initial injury. With insurance coverage finally (through the NJ Family Care Program)- I contacted my primary care doctor for a referral to an orthopedist. The staff insisted I come in though and see their sports medicine specialist. Knowing how insurance companies tend to work, I reluctantly agreed.

Thankfully I DID agree to this appointment. This doctor was wonderful and knew what he was doing and looking for. He heard my complaints, took my history of the injury and then with a medical student watching - he started testing my ankle and teaching the resident at the same time. When he was done testing, while my ankle was throbbing, he had an action plan.

He felt he knew what was wrong with my ankle from his evaluations, but he set out the plan. First another set of x-rays. If the x-rays showed something - we continued in one direction, if they didn't show anything, then we would try a different path. I was game - at least it was a plan!

History - Part Three

The new air cast didn't do too much. But since the docs were pretty blase' about it all, I figured maybe it was all in my head and I should try and deal with it.

Late in September, we had the dedication of the new track and field where I coach. As a coach, and a donor to the field, I wanted to be there and so I went. It was a lovely service that preceded the dedication. Then we had to hike to the field for it's official dedication. I should mention that the school where I coach is located on a "mountain" - any of the fields or facilities are down the hill from the main campus. With my cane in hand and air cast on, I limped my way down to the field. By the time I got to the entrance of the field, all the other coaches were on the field, so I stood at the end zone and watched, aching ankle and all. After the dedication, I limped back up the hill to my car and drove home.

By the time I got home, my ankle was very swollen and painful. I propped it up on the couch with an ice pack over it and popped some OTC anti-inflamatories. By two hours later, when it was no better, I decided I had had enough. I was off to the ER and I wasn't going to leave until they put a cast on it.

This was actually easier said than done. The ER docs were quite agreeable to all my wishes - but they couldn't help me out. Only an orthopedist could "officially" cast me. I told them to call one.

Apparently, I interrupted his football watching on TV - because the little twerp that came as the Orthopedist was rude from the first sound out of his mouth. I explained my whole history to him, the various visits, the determination that I had a grade three sprain, the fact that I still had pain and swelling and that the air cast was not doing a thing to immobilize the ankle and give it a chance to heal - I wanted him to either break the ankle or put a cast on it.

He tried to talk me out of it and I wouldn't have it. He turned away from me mumbling under his breath and I called him on it. He said he wasn't and I told him I wasn't senile and he was being rude. If he couldn't attend to me properly, I would be in touch with his supervisor in the morning. He went to get the casting materials. The ER nurse and resident smiled at me and gave me a "thumbs up".

So, Dr. Twerp came back with the materials to cast me and at that point - he did get even with me. He made the cast high (almost to my knee) and built up the sole of it so that it was impossible to even gently stand on it. The tips of my toes barely peeked out at the bottom (and I have big feet). He made a big mess while he put the cast on (I think he probably hadn't done a cast since med school) and sent me on my way.



I spent three weeks in the cast - and that was three weeks that included marching band competitions and football games! My crutches got an excellent work out and so did I. Going up and down the stairs at home, I would sit down on the step and haul myself up step-by-step or slide on my behind coming down. I worked out arm muscles and quadriceps galore. I made it fun - well, as fun as you can be with a cast on your leg.

Mid-October I was back at the clinic and they removed the cast and FINALLY fit me for the lovely orthopedic boot. With immobilization for three weeks, my calf had pretty much whithered into nothingness - so I was determined to build it back up to where it had beed.

Finishing up marching season with the orthopedic boot was not that bad. The ankle had its good and bad days - but at least I could move.

The clinic docs told me when they removed the cast, that ankle sprains can take months to heal and I just needed to keep plugging along and push through the pain as I strengthened it.

Through cheer season and winterguard season, I did just that. I plugged along and pushed. The ankle would swell and ache, and I would raise it, ice it or put warm compresses on and take anti-inflamatories.

Deep in my heart, I knew this could not be how I was meant to live though.

History - Part 2

So - I got my appointment at the Orthopedic Clinic the last week of July/first week of August. At that time I was told I had suffered a "Grade III Sprain" - the doc actually told me I would have been better off breaking it (and I did give him permission to break it for me!). He said these severe sprains often can take up to six months to heal.

Not news I wanted to hear with the County Fair almost upon us and another marching band season almost in full swing.

So - he put me back in an air casr - for another four weeks. Told me to go BACK on the crutches and be as non-weight bearing as I could for about the next two weeks and come back again if it wasn't better.

So - I played the good little patient and as much as I didn't like being non-weight bearing - I did my best. The county fair wasn't too bad - I sit alot anyway "protecting" our exhibits. But trying to navigate the fairground in crutches was pure danger. People just didn't care and more than once I got a crutch kicked out from under me. Thankfully I could stand so I didn't hit the ground.

I kept myself to "doctor's orders" and the ankle still hurt. I made a follow-up appointment.

While I waited for the follow-up appointment, I researched grade three ankle sprains, and found that much of the research called for total immobilization of the ankle for a period of time. This intrigued me since my ankle was never fully immobilized. I never felt that the air cast did enough to mobilie or support the ankle - there was still too much movement in it.

My appointment came and went. I got there and because it is a clinic situation, even if you have an appointment, you are seen on a first come, first seen basis. While I was in line to sign in, several people cut the line because they were on crutches or canes (I wasn't at this time)and so I sat for hours waiting to be seen. I finally gave up and went downstairs to the ER and begged for a cast. They told me I would have to wait for the orthopedic docs from the clinic to be finished and come down before that could even be considered. I have another university game to work and couldn't give that much more time to waiting for them. So the ER docs did another set of x-rays and gave me a new air cast and said - buh-bye.....

Pain in my ankle and a pain someplace else as well.....

History - Part One

I decided to start this blog in order to keep track of and share the "adventures" of an ankle sprain which becomes or develops into an OCD lesion. This has been a almost two year adventure for me so far - though as I understand from communicating with others - it can be much longer.

With that said, I figured the first thing I have to do is start a history of what has led up to the present day. I titled this as Part One only because I'm not sure how many parts it might take to actually get up to speed. I tend to be VERY verbose and detailed when I write - so this could take quite a few parts....

So - without further ado.....

It was June 30, 2008. Ashley (our youngest child) and I worked concessions at the university for a high school level special invite football game. (Our marching band program raises funds by working a concession booth at the stadium - so this is what we were doing). We were parked in a lot the the northwest of the stadium.

When we were finished at the stand, a bunch of us were allowed to leave the stand. Ashley and I walked back to the parking lot. When we had almost reached the lot, I stepped on the edge of a pot hole, lost my balance and fully wrenched my right ankle. I really did a number on it - not just twisting it, but also going over it sideways as well. Ashley had to help me walk back to the car it hurt so bad. We got home and I pulled out the ice pack, parked my behind on the couch and spent the night with ice on and off.

The next morning, it was no better, swollen and the bruising was starting to spread that I decided to go the the ER and get it checked out. For once, my husband didn't let me drive myself (should have hit me that it really DID look pretty bad for him to go that far) - so he drove me to the ER - and dropped me off. By the time he and the kids came to pick me up, I had been through X-Ray and the ER doc was just giving me the downlow...

The doc said I had sprained it - that was all. He gave me an air cast, a set of crutches and told me to stay off it for a few days and it should be better - but if not, follow up in two weeks with an orthopedist.

I played the good patient and stayed off it for about a week. Wore the air cast for another week while I limped around. At the end of two weeks, it was not much better so I opted to call for an orthopedic appointment.

Not having any insurance at the time made this a challenge - so I called the orthopedic clinic at the hospital. Silly me - I thought having been an ER patient I would be seen in a timely fashion. Couldn't get an appointment for another two weeks.