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Old 11-06-2008, 11:33 PM   #1
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greeneyeses HB User
My chronic ankle instability story

Hello everyone. I just joined and I found this site while searching Google because I am bored and also having my second ankle surgery in a year on Monday. I know this is terribly long, but if you are anything like me, you like to know every detail of people's ankle injuries.

Before we start, I want to give a little background. I was 14 when I initially injured my ankle, and I am now 20 and in college.

In early 2003, my freshman year of high school, I sprained my ankle really badly by dancing. I think there was more initial damage than my general practitioner saw on the x-rays, but anyway I was put in a splint for a few weeks and did PT for awhile. They say that if you sprain your ankle in a month or two it should be completely forgotten. This was not the case. I have had chronic ankle problems ever since. It would come and go with minor sprains and some swelling, but I just assumed there was nothing to be done about it and it wasn't terribly painful.

Then, in 2007, the fall of my senior year of high school, my ankle started being intensely painful. I went to see my general practitioner again, and since I didn't recall doing anything to it, she sent me off to have an MRI. The MRI came back and I was ushered off to an orthopedic surgeon (actually the same one who did my mom's knee- small town, people). He said that I just had a problem with overpronation and that was what was causing the pain. Now, I knew about this problem with my arches, and I got orthotics from a pharmacy that didn't really help, so I stopped wearing them. The surgeon then sent me literally down the hall to the podiatrist to get custom orthotics. I saw this podiatrist for about 9 months or so, trying to figure out what was causing this pain. At this point, I was in pain so much of the time I had to take pain medication. Not very strong stuff- just Tramadol or Darvocet. First, he put me in a cast for two weeks because I had tendonitis in one of the ligaments in my foot. That helped for awhile, until I started walking again. Then the pain came right back. He casted my feet for orthotics and sent it off- those took about a month and a half to get done. Finally, when I got them, they helped a little but not enough. To make a long story short, we did a soft-tissue steroid injection and that didn't work at all. Then he got another MRI done. I went to talk to him when the results were in. The ankle had become even more damaged somehow. He suggested that I would probably have to get a fusion surgery (how do you jump from damaged ligaments to OMG TRIPLE ARTHODESIS!?), which I later learned was way too harsh for what was wrong. He casted my foot again because I had developed tendonitis once again, and we scheduled an appointment with an orthopedic group in the city I would be going to for college in the fall.

So opened a new chapter in the story. My podiatrist had hoped to send mE to my current surgeon who he'd known during his fellowship. Of course, I had to go through the peon doctors first. I was sent to a sports medicine doctor, who I immediately didn't like because he said everything that my other doctor said was wrong and I had this feeling that he really wasnít going to be much help. He had me get a steroid shot into my subtalar joint- which is where the inflammation was. Amazingly, it worked for about two weeks. I was pain free. Then it wore off. That sucked. I got shipped off to physical therapy, which didn't help with pain. We tried another one (which I think was done incorrectly) and that didn't work at all, just left me in a ridiculous amount of pain and with a huge bruise.

By this time, I was up at school already. Finally, I got an appointment to see the surgeon I had been referred to. I won't ever forget that day. October 30th. It was warm out and the sun was out. I woke up thinking that this was a day that would probably change my life. I got to the appointment and handed them all of my information- two MRIs, medical records, x-rays- and waited. Then my surgeon came in. He said almost off the bat after listening to my history and looking at my MRIs that he was 99% sure he could fix it. I felt like a huge weight had been lifted. He told me all about the surgery and how he would use a cadaver graft to fix the torn ligaments and tendons in my right foot. He said to talk it over with my parents and then schedule the surgery. I got a surgery date the next day. January 3rd became one of the most important dates in my life thus far.

Finally, the day of the surgery came. This was the first time I'd ever had surgery, much less major surgery. I was a nervous wreck once I got into my gown. It took them forever to get the IV into my arm because they can never, ever find the veins for some reason. Finally, they got it in and gave me some "happy medicine". I was glad that they did because they then had to stick a huge *** needle into the back of my thigh give me a nerve block and get me through most of the worst pain. Then it was time. My dad and step-mom left the room and they wheeled me out into the OR. I remember them arranging my arms and turning me on my side, and then I was gone. I don't even remember counting back from 100 or whatever.

I woke up from surgery probably two hours later, and was told that everything went really well. I spent about the next 5 days on the couch with my step-mom sleeping on an air mattress on the living room floor. I had to sleep downstairs because there was no safe way to get my loopy, cripple-***, 150 pound body up the stairs and down safely. I don't really remember much, except that I was in a lot of pain and the meds made me sick. I also remember crutching to the bathroom and almost falling. I found this very funny at the time. I guess that's what Valium and Percocet will do to you.

After suffering through 6 weeks of being non weight bearing at all, I finally got to walking in a boot, and eventually just in a brace with shoes. I did PT, got released in half the time that I needed. When I went for my 3 month follow-up, my surgeon was amazed at how well I was doing. He said it was because I am young, not overweight, and healthy. Also, I think he was comparing me to a bunch of athletes who did too much too soon.

So I went through my recovery and was walking fine and feeling pretty great, even though I still had swelling. My surgeon said that this was really a year long recovery process, but little did I know I wouldnít make it there.

In June, I was just walking down my driveway, in my really good trainers no less, and I just randomly turned my ankle. I knew that was not good. It hurt really badly and so I rested it for a week or so, and did the normal sprained ankle things. It didnít get better, but I didnít bring it up with my surgeon until my next appointment. He took one look at the swelling and put me in a walking cast. I was in that cast for about three weeks, and the swelling went down. At this time I also got new spiffy orthotics.

Then, as my ankle likes to do, it flared up again with no provocation in late September. I went back to see my surgeon, and he ordered an MRI for me. After the results, he didnít see really anything that would be causing me so much pain so he put me in a CAM walker again for a few weeks and sent me off with another joint injection.

Now for the most recent part of this tale. I just went back to my surgeon on the 4th and I had no improvement in my pain or swelling. I also had developed this strange popping and clicking in my foot near the heel. He really didnít know what that was. We agreed that none of the conservative treatments were helping, so we discussed surgery more in depth. This is the surgery Iím having Monday. Also keep in mind that this appointment was just a few days ago.

For this surgery, he just wants to go in and scope it out with some tiny incisions to see if there is anything obvious that would be causing pain (like a fragment of something). If he canít find anything, heís going to have to open up my lovely 3 inch long scar again and take a look. He said that if he does that, heíll do a Brostrom repair on my allograft. He doesnít think that Iíve ripped out my graft, but that I probably have stretched it out again. Sigh.

Also, I had a Rheumatoid panel done; he thinks that I might have RA which is kind of a long stretch but we both think that it would explain the random ankle flare ups that weren't caused by anything obvious. I'm waiting for those results which I'll get tomorrow or Monday. I'm just thinking it's going to be just great if I'm going into surgery and also am told I might have RA on the same day. That would be my luck.

So that is my long and drawn out story.

Also, here is what I got off the report on the last surgery (what he did):
Diagnosis: right peroneal instability, chronic ankle instability

Procedure:
Right Elmslie Ligament reconstruction with allograft, peroneal tendon tenosynovectomy, primary. Repair longus and brevis, fibular groove deepening

Apparently I also had a bunch of nasty osteophytes in there too. He had like 5 med students in there watching. I felt honored to be studied.

So really I just wanted to share my story to possibly help out other people and see if anyone had any advice on this.

 
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Old 11-07-2008, 06:36 PM   #2
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stepbystep89 HB Userstepbystep89 HB Userstepbystep89 HB Userstepbystep89 HB User
Re: My chronic ankle instability story

greeneyeses

Wow! You have had a rough time lately!

I hope things get better for you soon.

Keep us posted!!

Step

 
Old 11-10-2008, 09:56 AM   #3
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Join Date: Apr 2008
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chufna1 HB User
Re: My chronic ankle instability story

Just released last week from rehab for a modiefied Brostrom repair myself. 2 week NWB, 4 weeks PWB in cam walker, and 6 weeks in lace-up. PT started at 4 weeks PO. The swelling still get bad quick and the area over the bone anchors still hurts, but overall I am generally pleased. I am well ahead of scheduled, but am trying not to do too much too soon and reinjure the area.

I have extremely flat feet that cause some tendonitis and foot pain, but my surgeon says that will likely never go away.

Good luck.

 
Old 11-16-2008, 09:22 PM   #4
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greeneyeses HB User
Re: My chronic ankle instability story

Thanks for replying guys.

I am now about a week out from my surgery. Here's the details:

My surgeon scoped out the ankle joint and area around my subtalar joint and cut away massive amounts of scar tissue. He found my allograft to be in good shape, so I didn't end up needing the Brostom repair (yay!). I'm already walking on my foot with PWB in my CAM walker. I have, on the not so positive side, developed an infection in on of the two incisions. I just got prescribed antibiotics tonight (I am so thankful for Walgreens being open 24 hours), so hopefully that will help that out and it won't turn into anything worse. I get my stitches out on Thursday and get re-examined.

Apparently (this is the explanation I got from my surgery) some people when they sprain their ankle develop massive amounts of scar tissue (guess who is one of them). He cut out so much tissue I can actually feel that the size of my ankle has gone down, swelling included.

Hopefully I am fixed for a little while!

Heather

 
Old 11-18-2008, 07:29 AM   #5
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Re: My chronic ankle instability story

Hi, greeneyeses.

Glad things are going well for you, just wanted to wish you a good recovery, and to say one thing.

I had scar tissue removed from my ankle, it was the best medical decision I've ever made. My ankle still isn't perfect, but it's at least 95% better. It was done early this year, and, from about 6 weeks after the surgery onward, I've felt much better than I did at any point in the year before.

My surgeon told my husband I was fixed immediately after the procedure, but I knew it had worked when the splint came off, I got a look at the ankle, and that weird little spot that had always been swollen, suddenly wasn't.

Best of luck while your recovery continues. And take all of your antibiotics!!

 
Old 11-18-2008, 12:44 PM   #6
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stepbystep89 HB Userstepbystep89 HB Userstepbystep89 HB Userstepbystep89 HB User
Re: My chronic ankle instability story

Greeneyeses,

I am happy to hear things went well!

One little word of advice - watch out for those infections. Like Jane said, take all of your antibiotics!

Keep posting and let us know how you are progressing!

Step

 
Old 11-20-2008, 12:02 AM   #7
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greeneyeses HB User
Re: My chronic ankle instability story

Good news! I went to the doctor and saw the physician's assistant and it doesn't look like I have an infection. I'm finishing up the antibiotics just in case, but once the stitches came out my incisions improved. I got them taken out on Tuesday morning and I just changed the steri-strips and they look really good.

I was originally freaked out because they started leaking yellowish red fluid that looked really bad to me. Apparently that is normal because of the amount of fluid they pump into the joint to do arthroscopic surgery. She said I could be "leaking" until next week.

Anyway, I am progressing well and doing my range of motion exercises. I am PWB most of the time, so I get around pretty quickly (I go to a huge university, so that is a good thing).

Heather

 
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