ankle

So starting to walk without crutches in my house and reducing my crutch use outside the house and starting PT made this week exciting.  Except that it has raised issues that are very stressful.

I'm really fine in my house without crutches.  I even accidentally went downstairs without them once and was fine (and it was so nice to carry things upstairs using my whole hand).  I was doing so well that I tried just one crutch when I went to see Dr. Mind and get an oil change.  I forgot that Dr. Mind's office has only one rail on the stairs so the one crutch was a mistake.  I was pretty sore that day and swelled up more.  But it was nothing unusual.

Tuesday I started PT.  I'm a little anxious about PT because the place I go has people certified in orthopedics.  I requested one of them when I made my appt. and the receptionist did not seem to know what I was talking about.  And I did not get a certified therapist.  I have the same therapist I had before.  I like him and thought he did a very good job with a very bizarre situation before (ie there was no way I should have been doing PT and no benefit to it but I had to do it because of the doctor I saw before my surgeon.  My surgeon totally ignored her and said of course I needed surgery but she tried to make my medical record indicate I was WANTING unnecessary surgery.).  So I'm ok with trying him.  I am just a little wary because he has not been a therapist very long and I don't know how much experience he has with the combination of surgeries that I had.  They aren't extremely common, especially done together and my surgeon uses a different healing pattern than most other doctors.  So we'll see how it goes and I'll ask to change if I feel like he isn't ready to handle this.

He did the evaluation and started me on a home exercise program.  I actually have already gained ROM and increased all but 2 movements to the 2nd level of theraband.  My swelling is improving somewhat as well with the movement.  But it wouldn't be me if there wasn't stress.  I came home and when I was coming up from the garage (with both crutches) my ankle felt like it needed to pop.  You know that feeling that things aren't lined up correctly and they need to re-align?  That's what it felt like.  With the boot it can't do it but whenever the boot is off for exercises I am getting that sensation and a very, very loud POP a few times during each session.  From what I can see while focusing on the exercise and trying to control movements either my flexor retinuculam  or my posterior tibialis is coming out of alignment.  Or it is the medial ligament inside and I'm not seeing anything external.  I am hoping this is scar tissue or inflammation.  I know that my last xrays showed medial swelling in the joint spaces.  But I'm scared because POPPING in the past was very, very bad and I have learned to not trust my ankle so even knowing that it is probably one of those things it sounds awful and doesn't feel great.  It's not exactly painful but it's not exactly painfree.  I am very anxious to go back to PT Friday and hopefully we can get it to do it while he is working on it.  It constantly feels like it needs a good passive stretch which I know better than to do (but which I did for years to get the tendons on the other side back in their groove so it feels natural to do it) and I'm hoping it will pop for him when he is doing that.  While I'm anxious and wishing that I'd had an MRI that I chose to not do pre-op to save money so that I would know if I had a problem on the medial side (there was popping there after a fall down the stairs in the spring) that wouldn't have been seen with the scope.  I'm terrified something else is wrong and that I'll need more surgery.  There is some ground for concern if it is the posterior tibialis as that was affected by my severe sprain but recovered which is unusual for that tendon apparently.  But I've had enough surgery to last a while.  I know at worst I have another procedure and it is fixed but I just can't see another 4-6 months of healing and medical bills.  So I'm scared.  It will be fine but it's hard to not be afraid after so much was wrong for so long and while my ankle is still so fragile.

I'm actually going to be remarkably busy for me for a while.  I'm not sure how that will go.  Next week Dr Mind is on vacation.  I may have to go see Dr. Body for a rash that isn't healing with the stuff he prescribed though.  I have a dental appointment Tuesday and PT 3 days, including nearly immediately after my filling Tuesday.  Then I see Dr. Brain on Saturday, my last Saturday appointment with her.

I need to talk to her and Dr. Mind both about my great fear.  I keep dancing around it with Dr. Mind and that's not enough.  I am very afraid of what will happen when my brother is arrested and goes to prison.  Initially there was shock and intense anger.  That is gone now and I just feel deeply sad.  OK and angry and many other things that mostly only come out when I try to talk to Dr. Mind.  I am crying every week with him and it is always about the same thing.  But this time those emotions aren't going to get me through.  This time it is going to be about the sad and the loss and the horror and quite likely the embarrassment of people knowing and gossiping.  People know but it will be worse when details come out.  I won't have those protective emotions this time and I know already my mom is going to lose it.  And I'm afraid that I won't be able to handle it.  I am afraid that this is the kind of thing that could trigger a hospitalization because one of the worst parts for me is that I can imagine all too well the victims.  And when the details that I know already are very, very bad come out I am afraid that I will be blasted into PTSD hell.  It happened before and honestly then it mostly helped that the extended family's reaction was nearly always to first ask if I was ok because it was so clearly a bad thing for me to experience.  Dr. Mind will nearly definitely be here so that is an enormous blessing because trying to handle that with someone who doesn't know my past would be terrible.  But handling this will be asking so much of me.  The night/morning that the awful phone call came my mom mouthed to me that my brother was in jail.  I knew immediately why.  I don't know how or why I knew but I did and when she wrote down the details for me I threw the notebook clear across the room which is a great room living room/kitchen so a long toss.  Fury was my first response.  Now that's gone.  Well, it's not, but as I keep telling Dr. Mind it was a lot easier the weeks I thought of him as a monster and a lot harder since I know he is still a person, just one who did some terrible things and will pay for them.

So anyway, hopefully I am brave enough to talk to Dr. Brain about this and then Dr. Mind when he is back.  I think he knows what I'm not saying but I'm not sure he does and he needs to know before it happens.  Based on averages that will be around November probably although it could vary hugely for all kinds of reasons.  I know how things work for my family though and it is very likely to be just before Thanksgiving.  Holiday wrecking is a tradition in our family.

So ankle and mood both hurt.  So does my rash.  That looked like yeast originally but now just looks nasty.  I can't see Dr. Body until Wednesday so it better control itself that long.  Ick.

And I think I've put my cat off of a feeding as long as is possible.  Poor sweet girl has been going through a not eating much but wanting lots to taste phase.  Those are so hard for me because I throw out vast amounts of uneaten expensive food.  It still beats cleaning up bloody vomit but at this point she is getting more of my budget than I am.  Which is ok since I'm mainly wanting to eat fruit and cottage cheese which is at least cheap.  And after I feed her I need to take the splint off and do ROM one more time.  I was up really early to take my mom to a colonoscopy so I am hoping that I get to sleep sort of early.  I've started using a little valium if I'm up at 3 but it still scares me to death because I'm nonweightbearing at night with my splint on and am wobbly on crutches, yet there is no way I'm going to try to sleep with a 3 lb boot on.

Things are kind of hard here.