The Time Line...

Helloo There!

Please read a couple of the other posts before this one... so that you have some background info and you know what caused my break and the severity etc! 

I am going to post here, a timeline of what happened to me post surgery and throughout the recovery so far. 

February 20th: 

Trimalleolar Fracture & Surgery 

February 21st: 

Left Hospital

February 28th: 

I returned to hospital, 7 days since the surgery - to have my back slab removed and to get a real cast. The stitches were also supposed to be removed.  

A consultant who I had not met before came over to me and said 'you're the girl with the triple break from last week aren't you... I hope you know how lucky you are to have your ankle, it was a very difficult surgery!' 

I was told of how serious the break/surgery was and informed me that I would come back again in 1 week to have the stitches removed and a fresh cast. 

March 7th: 

I had my cast taken off and my stitches pulled out. I was given yet another fresh cast and an appointment was made for 5 weeks time where I would hopefully be out of the cast for good! 

Between March 7th and April 4th:

I struggled a lot. 

It was hard to deal with losing complete independence. My mother had to do everything for me. I had to ask for everything from getting a tissue to blow my nose, to using the bathroom, to having a glass of water or my phone being too far away from me. 

I spent most of my time laying down, leg raised on 4 pillows. It took me a while to get a good layout where I could actually feel comfortable with my leg raised! 

It felt like the longest 4 weeks of my life and during this time I cried an awful lot. My mood was so low and I was so unmotivated. Trapped inside, by myself for full days, 5 days at a time. 

It was very lonely for me personally. If you have a large family or a husband, kids etc your experience will be different! And of course if you have things like a good wheelchair, a large car, good access to your house... then you could go out. Unfortunately for me, all I had was the zimmer frame and to get into a car id have to walk up a long steep sloped stoned drive way, to get to the road. 

I was to be completely non weight baring. A couple of times I stumbled, even with the zimmer frame - and ended up putting some of my weight into my foot which caused an immense amount of pain. 

I was desperate during this time to know how long it was going to be... how long was I going to feel so depressed... feel pain... how long would it be before I could go for a walk or return to sports. 

April 4th: Felt better than Christmas

I had my cast removed and went for some x-rays to see what the progress was! 

The outer side where the plate and 10 nails are - on the Fibula bone where I had the large, clean and diagonal break - the bone was healing quite well. There was still a visible line on the x-ray but the consultant seemed to think it was good. 

Unfortunately on the Tibia, the inner ankle - where I have 1 large screw, holding 2 pieces of bone to the main - the healing was not doing so well. There was still a visible space between them. 

However, I was still told to go home and to start doing gentle movements and work up over a week or 2 weeks - some weight baring and walking. I was warned that going too fast or expecting too much would mean disappointment and no progress. 

On April 9th/10th I took my first steps, since February 20th. It felt like nothing I had ever felt before... just pure elation. I was so pleased with myself! 

May:

I saw a physiotherapist for the first time. 

I had already looked up some exercises myself online and had been doing those. So the physio was quite surprised at what I could already manage to do just 10 weeks since the operation. 

Much to my disappointment, I felt like the physio meeting was pointless. The young girl didn't know what a CAM Walker is (american term) or a Beckham Boot (english term). 

I was trying to request a boot from her - as I felt very unstable and had been offered no support for the ankle whatsoever. You know... those large boots with the thick soles and velcro straps... I wanted one of those ugly things to make walking easier, esp leaving the house! 

I was walking OK at this point, slowly but surely. I had no crutches and had started using the zimmer frame less and less since mid April. 

I was given crutches during this first physio assessment but I pretty much hated them! I didn't feel like they did anything for me. 

June:

I had another physiotherapy appointment two weeks after the first, with someone else. 

A guy who was in his 40s and seemed much more experienced than the young girl I had seen previously. 

He asked about the background information, what I had done in terms of exercising and assessed what sort of things I could manage. He gave me 3 main exercises to do, for 3 weeks, then I would return to see him again. 

I was walking around my house freely... but still suffering from a lot of swelling. I could not fit a shoe on my foot, 2 sizes up from my regular size even. And when I did put one on it caused a lot of pain! 

Late June:

Over the 3 weeks, I did a lot of exercising of the ankle - but not as much as I could have. This was mainly because it caused some pain and discomfort as well as just forgetting some days! 

Still - I made huge improvements. 

The swelling in those 3 weeks had reduced by a lot! And I had a lot more range of movement. 

The physio tested the strength by making me push with the balls of my feet, into his hands... and from side to side etc - he said that the broken one almost felt stronger than the good one!!

After this appointment, I didn't see him again or any other physiotherapist. 

Getting your ankle back and doing the exercises it needs - is ALL up to YOU and YOU alone! Your progress will reflect directly how much work you are putting into it. Massaging, putting cream over the scars, stretching, doing little exercises, elevating it a couple of times per day.... it is all about how you much do. 

In those 3 weeks I didn't feel like anything had changed... but the physio basically called me crazy! And by the end of the session I realised that I made a ton of progress in that short time. 

July:

After the latest physio appointment, I was discharged as an out-patient. They did decide to leave my notes open for 6 months though, so if I had any problems and wanted to see them I could still call and get an appointment on the first available Friday. 

At this point, I didn't think I would need to go back. I thought I would, just for a check up and assurance that it was all healing well. 

During June and July:

My walking ability improved a lot, the swelling was slowly going away and I could wear shoes again.

I could leave the house, go to the supermarket, walk around a few stores without feeling too tired. 

Anything longer than 2 to 3 hours out, would mean exhaustion for my ankle and foot though.

I also had a task from physio, to walk a few times a week, for as long as I could and when I started to feel pain, to stop. I built this up from 9 minutes, to 15 minutes, then 20 minutes over a 2 week period. 

The main problems I had were really just feeling discomfort in the ankle... it always seemed to feel a bit like I was dragging a rock around with me. It felt like dead weight for a long time! 

August: I return to the Fracture Clinic

I had a few moments throughout the 6 months, where pain was bad. I would have a good day and walk a decent amount but pay for it by being stiff and sore for 2 days afterward. 

I began feeling an aching pain, first along the outside of my leg/ankle where the plate and nails are situated. Then this progressed to the inner side, where I would get extremely sharp pain that takes your breath away or brings tears to your eyes. 

I had already a booked an appointment for August 29th as I was moving out of the area and wanted to have my final check up and x-rays before I left. 

I couldn't wait until the 29th though... a week earlier, I decided enough was enough and called on a Monday afternoon hoping for an appointment that Friday. I spoke to the matron and she invited me first thing Tuesday 19th. 

During the appointment, I had the consultant tell me that my x-rays now 6 months since the incident, were showing great healing on the outer fibula but the inner tibia is still showing signs of a gap, like a fracture had just happened. 

They believed that possibly the screw is causing the pain, being situated too far inward to the centre of my ankle where all my main nerves are. 

I asked if I could please, finally have some support for it as I was now going back to being a hermit and never leaving the house! For once I was listened to and was given a cam walker/beckham boot. 

September:

My ankle felt SO much better whilst wearing the boot. It gives great support and makes it feel like you aren't really standing on your own foot. It was the support that I had been waiting for! 

However... it is a love to hate relationship. The boot helps but if you wear it for more than an hour or 2, it gets very tiresome. 

Using the boot seems to throw out the rest of my body, my natural walking position is altered by it and my right leg tends to take most of the stress and weight. It really is exhausting! 

After a couple of weeks, wearing it no longer means being pain free. 

I felt really agitated. Annoyed that this far down the line, I am going backwards. 

I really believe that this is due to not being offered good support at the very beginning. When my cast was removed, I should have been given a boot. I have seen so many people, with just one fracture of the ankle or foot who have been in cast for 6 weeks and then used a boot for 6 weeks as well. 

After all... everyone kept telling me how severe my injury was - but then I get told to just walk freely barefoot after 7 weeks in cast and a serious operation. Other people who had not had surgery at all were walking in and out of the fracture clinic wearing boots every week that I attended! 

Quick advice: if you have a triple break, if you have had surgery, if you are in cast now... please make sure that if you are told you do not need anything to start walking again and begin your recovery - you must insist that they give you a boot. Not a little plastic lace up sports piece of junk for someone who has sprained their ankle or twisted it.... a proper full boot!! 

October: 
Since using the boot from September, I returned again. This was due to problems with pain. I also was due to have a follow up, to see if wearing the boot had helped the pain or had even helped to heal the inner fracture.

The x-rays showed the same old story. And I told them that I had still been experiencing the awful sharp pains to my nerves... you can just be walking along and suddenly - it feels like ice cold water on a couple of sensitive teeth - but on a much larger scale and in your ankle.... lol... thats the only way I can describe the awful heebie jeebie feeling it gives you.

Its like a major shock, then every next step you take until you sit down, you feel it over and over.

I have been referred to have a CT scan now to further investigate... the consultant would like to know more clearly whether I have fibrous union. Simply, this means that the bones have failed to mesh back together or heal fully.


9 Months and 10 Days have passed...

After December 3rd I will have had my CT and my appointment for the news will be on December 18th.

I will either be having the screw removed, to hopefully stop the nerve pain. Otherwise if the CT scan reveals definite fibrous union, I will be going under the knife again to have a bone graft.

Surgeons will be taking bone fragments from a deceased person and mixing a paste to fill the fracture with and then re-insert another screw into a better position. This means being in cast for 8 weeks and a very long recovery again.

I suppose all I can do now is hope... and wait for the news.

I will update here again once I know more.


Don't Lose Hope... 
For those of you reading this at the start of your recovery journey please have faith. You have to work hard to keep your spirits up and know that it will not be forever. You will be on a roller coaster of emotions and some days will be good but some will also be bad!

Please know that this is a very individual process... recovery depends on you and your own body.

Unfortunately for me it has meant a second surgery is on the horizon, through no fault of my own... but such is life.

For you, it may be different. There are people who suffer from this injury and have surgery, then 10 months or 1 year down the line they are running and jogging with their normal life having been resumed as if someone just pressed pause for a moment.

If you would like to know anything more or you have any questions about something specific... please leave a comment and I will get back to you.

Also, if you are going through this... please share your story. I would love to hear from you!


Lots of Love..
Melissa x

P.S Here are a couple of pics from when I first saw what it looked like after 1 week in a back slab. It was very verrry swollen! 

A Quick Time Line... The First 3 Days

Hi Everyone! 

I thought I would post a timeline of recovery here first as I have noticed that traffic to this page is coming from Google. I assume this is because there are people out there who have found themselves in my situation with a triple break and may be looking for some general answers or a timeline to help you get through.

I wrote a diary once a week to keep track of my progress after my surgery. I have put these into fortnight or once a month so that the next post does not drag on for too long.

I have posted below, what happened to cause the fractures and the first 3 tough days. In the next post you will find a dated timeline.

February 20th 2014
At 8 am, I tumbled down 5 solid wooden stairs. The stairs were uneven, being larger and shorter, alternating in sizes. I tumbled down them in a couple of seconds and heard a very loud cracking noise before sort of "waking up" at the bottom of them, on my hands and knees.

I put my hands back and pulled my legs out from under me.

I couldn't really feel any pain straight away besides my ankle now feeling like a very heavy rock! It was hanging off to the left and a bulge almost the size of a tennis ball was sitting on the top of my foot. Part of a bone was also piercing my skin.

I tried to rest it on the floor but as I did, I screamed - there was the pain - and I had to hold my leg off the floor by wrapping my arms around the back of my knee.

During this, I was crying on and off and had been shouting out for my mother.

I pulled myself up on one leg, using a chair and had to throw on some clothes as the ambulance arrived within 3 minutes.

I was given a lot of morphine which didn't seem to make much difference. I also had gas and air. The two paramedics had to strap my lower leg and foot into a splint before they could get me out of the house. Again, there was the pain I had been waiting for!!

I fell just after 8 am and by 8.45 I was in A&E being assessed.

February 20th - The Surgery - Just 5 hours after the fall
When I got to the hospital I had already the asked one of the paramedics to be completely honest with me. I asked her what she thought was wrong and how serious it seemed. She told me that she believes I would need a pretty serious surgery on it.

I burst into tears as she said this and started having awful thoughts about losing my ability to walk, thinking how I was going to carry on going to University... and eventually thought oh my word what if they have to amputate my foot!

I am not a dramatic person. I swear! But these thoughts go through your mind, as it is such a huge shock and you do not know what to expect.

I had to have my ankle pulled back into place as it was of course dislocated and broken in 3 places. They call this 'reduction'.

I was given another shot of morphine and then ground my teeth together - as a surgeon and doctor manipulated my ankle and pulled it back into a 'normal' position. They then put the splint back on.

I was taken into another unit after that where I was awaiting my x-ray results which they had done when I arrived.

I was then spoken to by a Dr and a Surgeon - who came to tell me the results - they said I would need immediate surgery involving a plate, some nails and a screw. They believed it had to be done quickly as there was a high risk of losing blood flow to my foot. They also explained that it was going to be a very difficult surgery based on how the bones have broken and where they had moved to.

I was devastated.

At the same time, pleased that it would happen fast and be over with.

I opted for an epidural - as I was told it would be only be about a 45 minute to an hour surgery. I hated the thought of being knocked out on anesthetic and waking up not knowing what the heck had gone on.

Unfortunately, after sticking 2 different sized needles into my back - 4 times - they said it was not possible. I laid down and had a mask pulled over my face, with absolutely no warning I was out like a light.

February 21st 2014 
I spent the night of the 20th, and all day of the 21st in hospital. I had a large and very heavy 'back slab' on my leg which is like a temporary cast. There was too much swelling to be able to get me into a cast comfortably.

It had a strong metal piece down the back, from your knee and down into the foot and it was wrapped in loads of bandage.

After coming out of surgery, I was extremely pleased to be alive! And also to see my mom who I could see, had been through a hell of a 48 hours.

She couldn't stay long, so I spent the night feeling quite teary. Staring out of the window. I desperately wanted to sleep but I was being woken up every 2 hours to have my blood pressure and temperature checked!

I was struggling a lot, to go to the bathroom. The morphine was making me deadly thirsty, so I was drinking jug after jug of water and needing to wee often!

I was given a commode next to the bed and I would slide myself down to the bottom and then attempt to get myself onto the chair by hanging onto the bed rails. It was really tough.

The nursing staff were atrocious. When they emptied the commode, they would move tissues that I was using to wipe myself - to the other side of the room. Or actually move the whole chair away from the bedside.

When I needed to wee, I pressed the buzzer and waited over an hour for anyone to show their face... no one did. I was sat at the end of the bed, in tears, desperately trying not to wee all over the bed and floor. I finally shouted out for someone and they came in and moved the commode close enough and gave me a box of tissues. They then closed the door and walked away... so I struggled alone to get myself back into bed and raise my leg on some pillows - all on my own!

After feeling like I had lost EVERY ounce of dignity I had, due to the staff being so... insensitive.. I knew I had to get out of there and no matter what anyone said, I was leaving that day!

At about 6 pm, I saw 2 physiotherapists who gave me a zimmer frame. I was too unstable for crutches. I didn't care what it took or what I had to use, I was going home!

So at around 7 and with a lot of convincing, a nurse showed up with a discharge letter and said I could go.

February 22nd 2014
I woke up at home, in my own bed... finally. I was in a lot of pain and discomfort and feeling pretty sorry for myself!