ankle at 18 weeks: no sign of AVN… yet

And the news in ankles is, two steps forward and one limp back. I’ve been working that left leg really hard, with the result that I can now put weight more or less anywhere on my foot I like and have a more natural stride again, but with the price that range of motion in my left ankle has decreased considerably. The muscles and tendons near the back of my heel (Achilles?) are really sore and tender. Even the physio commented yesterday on how tight things were and didn’t give me any new exercises to do, telling me to keep doing what I’ve been doing and take breaks as I felt I needed to do. Accordingly, I’ve been taking it easier lately… but I’m still going to blues dancing late night tonight, with an ankle brace, so help me.

Today was what might be my last Fracture Clinic for a while, and was a good reminder that even physicians within the same specialty and viewing the same injury can have quite different outlooks and opinions. The first doctor promised me that my ankle would be stiff for the foreseeable future and would “never feel like it used to”, a prospect to which I’ve resigned myself at this point. (In contrast, the physios seem to think I should be able to get most of my function back.) For some reason my X-rays got handed off to a second doctor after the first one told me to get them taken. Doctor #2 looked the X-rays over, frowned, spouted off some Latin at me and then told me that seeing a particular bright feature in the image was a good sign, for reasons he was subsequently unable to clearly explain to me, though he did tell me all about AVN again for the first time for the last time. Anyway, my prognosis is apparently “pretty good”. Since my fracture was undisplaced he’d expect the chance of AVN to be 10%, but since it was through the body it could be as high as 90%. While not exactly zero information, 10%–90% is a pretty wide range; it would have been easier for him to say “we don’t know”.

The one thing Doctor #2 did know was that I’ll know if AVN sets in: I’ll start feeling pain in the injured ankle with the slightest weight put on it. The pain of dying bone, he called it. It should be obviously distinguishable from the soreness and stiffness of tired muscle which I’m feeling now. If I feel that I am to call them back pronto. If I don’t feel it, they are apparently done with me and it’s up to me and the physiotherapists now. I find that surprising, since other doctors made it sound as though they would be monitoring me periodically, buuut if I can feel when it happens, it might not be cost-effective to monitor me. Anyway, we’ll see.

One final encouraging thought: my health insurance is doing what it’s supposed to. Although it is taking forever to process, they have so far not rejected any of my claims. Woohoo!


About Richard

I'm an American scientist who is building a new life in Australia. This space will contain words about science and math, but also philosophy, policy, literature, my travels, occasional rants, all sorts of things I find strange and awesome. The views expressed in this blog do not necessarily reflect the opinions of my employer at the time (currently University of Sydney), though personally, I think they should.
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