achievement unlocked: partial weight-bearing

At my most recent Fracture Clinic appointment on the first Friday in July, I was told I could start bearing weight on my left foot again, and — to my surprise — that I didn’t need the boot anymore! It’s beneficial not to have it on, the physiotherapist said. Apparently the sooner we get my ankle back to doing semi-normal things, the better.

But has the bone joined? Apparently my X-ray looks the same as it did a month ago. We try to strike a balance between not letting you walk and having the muscles and tendons waste away, the ortho told me. We don’t like keeping people off their feet for more than three months if we can help it. So while that didn’t exactly inspire confidence, the screws are holding the bone together and I can apparently let pain be my guide here. Great. To that end, I’ve finally been given exercises to do: 15 minutes heat compress, then 20 reps each of plantarflexion + inversion + eversion, at least 3x daily but more often if I can manage it. Emily and I bought a bean bag filled with wheat kernels, which we can microwave; it smells like porridge when it’s done.

The instruction I got on partial weight bearing seemed subjective at best to me. Supposedly, keeping my feet halfway between the crutches will give me 50% weight on the injured foot. But in reality it also depends on how much I lift myself up off the ground while stepping. The physiotherapist told me “not to skimp,” but in practice I tried from experience to calibrate the amount pressure on the sole of my foot corresponding to 50% of my weight. Fortunately I knew from dancing (and common sense) that standing with my weight split right in the middle constitutes 50% of my weight on each foot, which helped enormously. Sometimes I still pick my foot up if I need to motor, e.g., across the street.

While the swelling is better than it was, it’s been an ongoing fight to keep it down to allow the joint to re-mobilize. I got a surprise when, on the first day of putting my foot back down, I experienced not sharp pain but a dull ache and tingling, like pins and needles. Shortly thereafter my entire left leg from the calf down blew up like a balloon. I’m assuming this was not ideal, but probably par for the course I’m on now — it was the first time that leg has seen any weight in three months. So while the physio originally gave me a compression bandage covering only my ankle, I’m now wearing a knee-high flight sock on my left leg. This seems to have the desired effect. It certainly looks healthier and doesn’t feel like it’s cutting off my circulation.

Anyway, assuming nothing breaks down horribly, by next week I’ll be 100% weight bearing on the injured foot, and the crutches will just be there to catch me in case I stumble.

The ortho also revived the spectre of AVN before I left Fracture Clinic. This apparently can set in as late as two years after the fact, so they’ll keep monitoring me for at least this long. They have no idea whether the blood vessels in the bone have healed, and the first sign that they haven’t will be the bone crumbling. Awesome. I reeeaaally hope I have a year or two of walking before that happens.