It isn’t common, but it happens. My battle with osteonecrosis (ON) or avascular necrosis (AVN), began, not in my hips or knees, the most common sites for ON, but in my ankles. Walking to get the mail one day, I felt like there was ground glass in my left ankle. The pain stopped after a few days and started again after several weeks. This time, my left ankle felt like I’d broken it. I’d had a broken ankle before and I know what that felt like, so I can make that comment!
My doctor ordered an MRI which revealed ‘multiple bone infarcts.’ Being the inquisitive sort, and also having a background so that I could read the report and understand the ‘doctor-speak,’ I was able to reason out the rest and with the help of my doctor, learned over the course of years, the ‘ins and outs’ of osteonecrosis, so it didn’t terrify me!l
I learned that even though it was found in the ankle, it wasn’t that often. More often than not, ON made its first appearance in the hips and knees. Other MRIs over the years showed that it was in both hips, knees, tibias (Shinbone), ankle bones, heels and one shoulder. Mr. Yuck! I tried conservative treatments, but eventually had one knee, one shoulder and most recently (in 2013) my left ankle replaced.
Ankle replacements for osteonecrosis aren’t common, but I was too young not to do something. This surgery, normally a 5 hour procedure, took 2 1/2 hours. Not because I was a stellar patient, but because my ankle had so disintegrated such that the surgeon had a much easier time than anticipated in removing the necrotic bone.
Then it was sit and wait for a bit more than three months. I was in the hospital for 5 days and I was in a physical rehabilitation facility for THREE months! My husband and dog and home were 1100 miles away for Thanksgiving, Christmas and New Years, so I formed attachments with another family. I also had the added benefit of having lived for some time in the town where I had surgery; so I had a steady stream, sometimes revolving doors of visitors. But, truth be told, I was alone most of the time and became my own best friend.
Because I was isolated, I had nothing to do but work hard in physical therapy. Twice a day, for 2 1/2 hours each day, even though I was non-weightbearing and confined to a wheelchair, I lifted weights and did other exercises in physical therapy. At the end of the day, tired from work in therapy, I barely had enough strength remaining to eat dinner. In bed normally by 6 PM (yes, you read right!), I was awakened by the nursing staff at 9 PM and then reveille at 7 AM, only to repeat the same drill the next day-FOR THREE MONTHS.
Rehabilitation proved tiring (I think it was more boredom) and my body was trying to heal itself and bounce back from major surgery. Bounce back? That was something for 22 year olds. I’m significantly older than a 22 year old.
When the day came to see the surgeon again, my husband greeted me at his office to get discharge instructions. We hadn’t seen each other (husband) in three months and what a reunion we had at the surgeon’s office!
Suffce it to say I wondered why I was so weak. The docs didn’t answer that question, but my physical therapist put it this way; “Annie, think of it this way: When you’re in a coma, you lose @ 6% of muscle tone and strength a day. Granted you weren’t in a coma, but you were in a wheelchair for three months, so cut yourself a little slack; give your body time to strengthen itself. In as much as I took that advice to heart and although I have a fracture in each foot, I am able to walk normally-or qt least much more so. So, here is a video of my walking, somewhat unsteadily, (but walking!) 7 1/2 months from my ankle replacement. My ‘new’ ankle flexes, extends, goes through all nothings except inward and outward motions. I can do most exercises except for running. The impact of a gentle jog was too much. But my muscles are so weak
But I can walk. No more ground glass. I had to learn to walk all over again and now I can walk 7 blocks in the neighborhood. Given that ankle replacement are in their infancy, I will say this: “Surgery is a breeze (You’re asleep!) and rehabilitation is easy (boring, but easy) and you need to work hard in physical therapy. But, I’ll say this: If I had it to do over again, I would” Bottom line, the process was easy and lengthy.
I was asked to post a video when I was nearly 8 months from surgery. So, here it is.
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