Monday, December 10, 2012

Dancing (or close) On a New Ankle

     Most of you know I've been suffering from post traumatic arthritis in my right ankle for the past three years.  I fractured it in 1985 and had since worn out the cartilege in that joint so that it was all bone on bone.  I was told to wait as long as I could, since they were improving the procedure all the time.  We pretty much set our sights on this Fall when I would turn 65.  My Medicare kicked in on Oct. 1st, and we didn't waste any time.  As soon as I got the Medicare paperwork in August, I called the Dr's office in Mesa, AZ, and made an appointment for 9:30 on Oct 1st.   He sent me for a CT to evaluate the surrounding bone in the ankle that same afternoon.  All looked well and we set up a preop appt. for Oct. 18th and scheduled surgery for the 24th.
CT Machine
     Gary, I and Bandit left RoVer's Roost in Casa Grande at about 7 am on Oct. 24th, and arrived at Banner Desert Medical Center in Mesa at about 8:30am.  Gary dropped me off and I started the check-in process, while he got the Class C  parked in the designated area, where he & Bandit would stay.  They were even able to have electricity.  Gary then came to meet me.  I went through the prepping procedure and Dr. Maling came to see me, initial my ankle (see picture), and check for any last minute questions.  Things moved fast after that and it seemed I was being whisked away quickly.  Surgery lasted about 2 1/2 hours and went as expected.
Before surgery with Dr. initials

     By that afternoon I had a brand new Scandinavian Total Ankle Replacement (S.T.A.R.) in my right ankle. I came back to my room quickly and was told to order a meal by phone.  They gave you a menu and you ordered by phone, to have your food delivered about 30 minutes later.  The only complaint I had about the hospital, was this procedure immediately after surgery.  Still under the influence of anesthetic, drugs, and hungry from being NPO since midnight, I didn't make the best choices for my meal and suffered the consequences later with vomiting several times.  I was still queasy the next day and wound up spending a second night in the  hospital.  Other than that, the facility was great.  All rooms were private which was really nice for leaving the TV on all night and getting up and down during the night.

     My foot was wrapped up in a half cast, with a cold pack on it at all times.   The remainder of the hospital stay was uneventful, thankfully, and at about 12:30 Friday, I was released.  I was wheeled out, while Gary went to get the motorhome.  He enjoyed two good night's sleep in the Class C and going out to walk Bandit gave him some much needed relief from the hospital.   The expression on the aide's face when she saw the Class C was priceless as she asked how I was going to get inside.  Gary and I had practiced the day before surgery and had it planned out.  By sitting in the doorway and using the handle to lift myself up I backed in on my bottom.  Then up and onto the couch.  When I looked back at the aide, she said she wished she'd had a camera to video it, as it went so smoothly.   It was another smooth transition into the fifth wheel, (also practiced before we left), when we got back to the park.  I took up residence on the couch, which we had made out into a bed before we left.  That was where I slept for the next six weeks.  We had a beside commode, which was I was able to use by myself, allowing Gary to sleep through the night.
      I was non-weight bearing for three weeks, basically laying on my back with my ankle elevated other than when I got up to use the bedside commode.  While laying on your back watching TV and reading may sound good, in practice it's really boring.   Thank goodness I had friends stop by to visit.  Gary and I really appreciated the friends that brought us meals. 
     I went back to the Dr. at 1 week, when he x-rayed and put a new cast on it.  At week 2, he took the cast off, giving me a large boot, but still no walking.  At week 3, he removed the stitches and I started putting 25% of my weight on it, while wearing the boot and using a walker.  At this point I started physical therapy to increase movement.  I added 25% of my weight each week until I could put total weight on it last week.  I'm still wearing the large boot and using a cane for one more week.  I will go to a brace with tennis shoes later this week.  There has never been any pain in the joint itself, but boy do the unused muscles around the joint complain as I work to get them going again.
Week 1
Boot at Week 3

Week 5
     Gary did a wonderful job as caregiver and of course had to to everything, as far as shopping, cooking, cleaning, laundry, etc.  He did make one comment wondering how I had done all that when I was working too.  He even gave me blood thinning shots in my tummy, for the first 14 days to prevent blood clots.  I think he kind of enjoyed that part and was disappointed when that ended.  He sure had good technique though.
     Physical therapy consists of exercises, foot massages (which I love) and electrical stimulation with ice for the first few weeks and now heat.  I still have 3-4 weeks of pt to go.  I had new X-rays last week and all looks good.  These pictures are of the standing x-ray equipment in the Dr.'s office.
Standing x-ray machine
Checking X-ray

     Finally, here is my new ankle from 3 views directly facing the front, at an angle, and from the side.

   You can see the two metal pieces attached to the tibia on top and talus on the bottom.  These are made of a combination of metals called cobalt chromium alloy, coated with  pure titanium where they touch my bone.  In between what you can't see is the mobile bearing made out of a medical grade plastic called polyethylene.  This moves between the metal parts as I move my ankle.  Pretty amazing we think!!! 
My goal has been to be dancing on New Year's Eve and that should be possible.  It may not be a polka, but I'll be happy with a waltz and good two-step.
     Gary hasn't played much golf, but continue to play pool daily and has entered a few tournaments.  I'm now able to get over to the clubhouse most days and play cards at night. It's sure great being out and about again.  We've had marvelous, warm weather up until this week, with highs steadily in the 70's.  It's hard to complain when the high's drop into the 60's, knowing how cold it is for our families in Wyoming and Utah, so I won't.  It hasn't happened yet this year, but we do have to drip our water or turn the outside water off for a few nights when temps drop into the 20's or lower.   That's winter in Casa Grande.   
     We had a very nice Thanksgiving, with a lot to be thankful for, as usual this year.  We joined about 50+ others in the clubhouse for dinner that afternoon.  The park provided the turkeys and we all bring various dishes to add to the meal.   Good food with great company.
     We'd like to wish you all a very Merry Christmas and a prosperous and healthy New Year.   We're looking forward to a more active 2013, with more dancing and hiking.  We'll spend the holidays here with our winter family and hope to have new adventures to blog about. 
     Dancing (or close) on a new ankle...............................
     Love and Hugs, Gary, Katy, Rusty and Bandit too.