I have reached the 6 month milestone of my ankle surgery.

Some time ago, I severely rolled my ankle in an unlucky accident (I had heard a loud snap sound too). For many months, I attempted to rehab the injury myself but something was not quite right. There was sharp persistent pain that was not getting better with time.

Eventually, I went to see a specialised surgeon. He was able to pinpoint and explain a diagnosis that was quite uncommon but matched what I felt. I was booked for surgery quickly after.

The surgery was for “excision of accessory navicular and tibialis posterior advancement repair”. In essence, one of the small bones in my foot had snapped off the main bone and become unstable. This was the cause of the persistent pain. They would remove the small bone, and transfer the muscle tendon attachment to another bone.

The surgery was successful. Recovery was tough, as I was told to expect. Post-surgery, I was completely non-weight bearing for 6 weeks, and had to wear the protective moon boot for 12 weeks. I jabbed myself in the stomach with blood-thinning medication every day for 6 weeks.

It is now 6 months post-surgery. I am about 40%(?) of normal function. The original issue seems to have been resolved, which is a huge relief. Now I am just working to build back to a level where I will be able to jump and run again. This is expected to be more in the 12 months timeframe.

Graphic warning: Before and after photos

Here are some of the things I learned from my experience:

Nausea

By pure coincidence, I had recently read a book “Complications: A Surgeon’s Notes on an Imperfect Science” on various perplexing medical phenomenons. There was a whole chapter on nausea – the TL;DR is that nausea is the second most common medical complaint patients have (the most common being pain), and is often overlooked because there is no real cure for it. It is ranked the worst part of chemotherapy treatment by patients, and can affect pregnant women so badly that it is the surprising reason many women don’t want to have children again.

Unknown to me prior to this experience, I react very nauseously to fentanyl and other strong pain-killers. By the time I came to this realisation in the hospital, it was already too late. I was already so pumped up on these pain-killers that I was in an extremely nauseous state and vomiting for the 48 hours post-surgery. The irony as I was recalling what I had just read, and experiencing severe nausea first hand! It is as bad as they said.

Patience and time

During each step of this process, it is easy to get caught up in the present. Pain fixes your mind to only see the present. There is already very little noticeable progress and difference from one day to the next. Pain in the present makes it even more difficult to imagine any progress and where my recovery could be a few weeks from now, or a few months from now. 

But time nudges us forward. As the days stretched into weeks, I started to notice small differences in the pain and swelling. As the weeks stretch into months, I can see some progress that was so hard to visualise before. This would be a good reminder for other difficult circumstances in life that seem to trap our thoughts to only the present. Time most often comes with change.

Improvement

Recovery and rehab is following a predictable pattern. The human body is mostly the same for everyone. Muscles function a certain way, nerves work a certain way, bones heal a certain way, medicines interact a certain way.

My rehab experience is just about following a simple formula.
1. Stressing my body to its current limit.
2. Resting to allow my body to recover and adapt.
3. Repeat.

At the beginning, this was taking my foot out of the boot for a few minutes a day. Then, just moving my ankle a couple centimetres up and down. Then, gently putting some body weight through the moon boot. Then gradually, walking a few minutes at a time. For each stage, I had to push to the limits of pain. And gradually, my body would allow me to do a little more.

It’s a lot of repetition and there is no real shortcut.

Appreciating small things

Post-surgery, I had my usual autonomy and independence stripped away. 

I came to appreciate the small things. Transitioning from a rigid permanent cast to a more cushioned moon boot. The few minutes a day I could remove the boot to wiggle my toes. Sitting in the sun and getting fresh air. The slow subsiding of excruciating pain and swelling.  

The first time being able to put weight through that foot. The first time being able to move around the house without assistance or supervision. The first time being able to sleep without the cast or boot on. The first time walking outside in many months.

There was a fresh sense of wonder and pleasure in rediscovering and regaining these things again.

Privileges and luck

For all the unfortunateness of the injury, there are so many privileges and so much luck that allowed me to be where I am today, 6 months post-surgery. Privileges of modern medicine – modern techniques, technologies, medicines, and all the countless inventions and progress that would have seemed impossible decades ago. 

Luck with having the surgery just before the start of the 3 month Delta lockdown in Sydney. With good timing, I was able to have the surgery without postponing or additional worries. I was able to have family as visitors during my hospital stay, and my mum was able to help me at home post-surgery. 

Privileges of having paid leave and being able to work from home during my recovery. Privileges of having private health insurance which allowed me to have the surgery on short notice. And privileges of having access to skilled physiotherapists to help guide my rehab process.

Final thoughts

Overall, I am really glad the surgery has been done. Before the diagnosis and surgery, I had half-resigned myself to the worst-case scenario that I would just have to live with the injury forever. Now it feels like I have been blessed with a lucky break, that I somehow stumbled onto a promising solution to a difficult problem. It’s a long journey, but it feels like all signs are pointing to a light at the end of the tunnel.