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FieryPrincess 04-22-2012 03:48 PM

Dr's appointment tomorrow
So I go in tomorrow to get the doctor's opinion on how my healing has been progressing.

I think the ligament part of the damage is resolving itself somehow to some degree. I think the initial injury was because of severe ankle instability and I don't think that the conservative treatment will cure that but at least it doesn't hurt there and that nagging feeling of stretching out bad elastic is gone.

I have been in the boot for 4 weeks. In the beginning it was unbearable to walk in it so I used crutches. I finally went back to full weight bearing just last Wednesday. It will ache quite a bit if I do too much walking. Since I work at a school that can accommodate 1200+ students, we have a large building and I am not even close to a bathroomm, lol. I curtail much unnecessary walking and my administartion has helped me to curtail lots of walking (no one bats an eye if I don't sign in, and my duty has been changed to eliminate 30 minutes of walking 3 times a week).

One of the problems I see is that reduced walking to avoid the deep ache is not a long term solution.

I am having lots of trouble reaching what is the best decision. There is more than just me to think about in the decision.
Also because it is the end of the school year and because we are moving 4000 miles away, I am not comfortable just ditching the whole end of the year. I teach a course where I see the same kids several years in a row and many of them will be hurt if I just disappear. Then again, if I wait until the school year is over, then we hit the road before I am weight bearing. I don't feel comfortable leaving my husband to handle the full details of this massive move and having to caretake me all at the same time.

I am down to thinking the best solution for everyone but me is for me to suck it up for the next few months to get everything and everyone finished up and moved. I'd have to include hounding the military insurance to make sure that permissions for future treatment are already in place when get to Alaska. I can do that. Then I just have to make sure that I have 60 days worth of pain meds to see me through end of the school year and the move.

Meanwhile my husband and I have put together some questions. I would appreciate feedback on them.

1) Exactly how big is the osteochondral lesion?
2) Please explain the feeling of heat flushing through the ligaments?
3) How stable/unstable is my ankle when compared to a "normal" individual
4) We are 15 weeks from the original injury. Pain is still present as is mild swelling at a point away from the ligament injury. What is the next thing to try now? If PT, then for how long?
5) Is surgery in my forecast? If no then:
(A) What will be the next non-surgical attempt?
(B) What are specific instructions in regard to walking - boot/brace? PWB/FWB?

If yes on surgery then:
(A) Then what is the recovery times and how long for
Elevated? NWB? PWB? FWB?
(B) How will this mesh with our move and a 12-day/4100 drive?

I appreciate input and feedback. I have also talked a bit with a counselor (I am so down about my health issues and this ankle problem) and we have been exploring why I become so passive and ineffective in front of a doctor when that is the exact opposite of my personality. I am looking forward to being more effective tomorrow.

Thank you!

FieryPrincess 04-23-2012 06:51 PM

Re: Dr's appointment tomorrow

I have a brace now and not a boot. The "ferrerari" of braces I am told.
We try this for six weeks.
He feels that surgery will not be needed since "these things heal by themselves 90% of the time."
The fact that I can feel bone hit bone in my ankle while I walk was attributed to that fact that I was wearing a generic boot which altered my gait.
When asked about PT to strengthen my ankle he said it was not advisable.

When I asked what the specific size of my OCD lesion, I was told that it was not a good idea to get a size since everyone measures differently. It was better to compare old and new MRIs.

When asked about another MRI, I was told that would also be a bad idea right now.

Pain meds are not advisable.

I really felt blown off, but I am kind of stuck with him because of the army medical system.

I guess I'll try a couple of things next:
1) Look for a second opinion
2) Do exactly what I am told and see how it feels in a two weeks. If it does what I think it will do, I'll call and demand another appointment.

kttyhom9 04-23-2012 08:44 PM

Re: Dr's appointment tomorrow
I was just reading your post and thought I would say hi. I am also a military wife currently station at Fort Bliss, TX. My husband is at the Sargent Major Academy. Where are you currently station? We will also be moving in a couple months but are waiting to find out where we are going.

I just fell and hurt my ankle on April 12th. I just picked up my MRI results this morning.

This is what they found:
1)Anterior talofibular ligament tear.
2)Small posterior tibiotalar and posterior subtalar joint effusions.
3) Posterior talus medially and medial malleolus posteriorly with mild bone marrow edema.

Not sure what all that means. I have a doctor appointment on Thursday to find out. All I know is I am having a lot of pain, my foot and ankle are black and blue. I do have some Tylenol 3 and they gave me 800 mg morton.

Keep me posted on how you are doing? Us Military wife have to stick together. Don't let them push you out. If you are having pain still get that second opinion. I will keep you updated on how my appt goes. I did post on another thread. Looking forward hearing from you.


Hollywood48 04-24-2012 12:55 AM

Re: Dr's appointment tomorrow
Wow. I'd feel blown off too. It's like every question/suggestion you had was met with a "nah, that's okay but thanks for playing!" ugh! So sorry! I would strongly recommend looking for a 2nd opinion. I realize this isn't easy because of the military, but I think it's in your best interest. At this point, with no clearer answers or diagnosis/treatment plan than what you have now, wouldn't do any major procedure before you move. Not enough time unless it's late summer or fall. Pain meds aren't advisable? Right, ok. Like pain is? Seriously??? Did you ask why they weren't advisable? Do you have a primary doc you could get meds from? I kind of get the measurement thing since everyone does measure it differently and you do compare MRIs for growth, but couldn't he have measured it to give you a base idea of what you are dealing with? Sometimes the procedures differ based on the size of the lesion. Not sure why PT isn't advisable unles there's something with the OCD it isn't good for. It's excellent for strengthening the ankle, getting proper gait back and controlling pain and swelling. And when was your last MRI? That would tell you if it's too soon for insurance to approve another one. I'm so sorry!! Keep us updated!!

KTTYHOM9--Hi and welcome to the boards but I'm sorry you hurt your ankle. Ankle injuries are no fun and very painful as you now know. Follow all orders and take very good care of it or it can lead to further injuries and possible surgery (I'm currently recovering from ankle reconstruction #2!). As far as your MRI, looks like you tore your ATFL. Most common ligament injured in an inversion injury or sprain. It is located just I'm front of your ankle bone (the talus or knobby bone that sticks out on the outside of your ankle) and slightly up. There's an area that sort of "sinks in" right there (when it isn't swollen). Joint effusions are swelling/fluid in the joint. Looks like you have. Small amount of this in your posterior tibiotalar joint which is the back side of the joint where your tibia (big lower leg bone) and talus (ankle bone) as well as in your posterior subtalar joint (back side of where your talus and I think calcareous or heel bone meet). And also none marrow swelling in your posterior medial talus (back inside part of the talus of one of the ankle bone) and the back inside malleolus (the small knobby part of the INSIDE of your ankle). Your doctor will discuss how bad it all is and what it all means. It basically sounds like you tore the most common ligament in an ankle sprain and you have a lot of joing swelling which explains the swelling visible to you and the bruising. May I ask how you hurt your ankle? I ask because you have somme outside and inside stuff going. Did you roll it out and in? Are you able to walk on it at all? If not, is it because you physically can't or because the pain is too severe? Glad you have pain meds. The Tylenol #3 will control the pain and the ibuprofen will keep the inflammation down. Keep it elevated (toes above the nose) and ice, ice, ice! This will help greatly with swelling and pain. Rest the ankle as much as possible. Good luck snd Let us know what the doctor says!

FieryPrincess 04-24-2012 05:10 AM

Re: Dr's appointment tomorrow
We're at Fort Sam Houston. You know -they've been setting it up as the new Walter Reed and what the military wants to hold up as the best that military medicine has to offer. If what my whole family has gone through is any indication, soldiers are screwed.

I plan to contact the guy that works on the Spurs and see if I can afford that second opinion.

We're headed to Fort Wainwright in June.

I am glad you have that Tylenol 3. I did not find the Motrin to be helpful for inflammatory issues.

Hey Hollywood, I forgot to throw in there that I was also told that I asked about the flushes of heat (which are indicative of nerve damage usually) in the ankle, he blew that off too and told me that because we had immobilized it for so long that it was like a poison and caused problems even as it helped with others.

That's when I asked about PT was shot down for that one too.

kttyhom9 04-24-2012 08:06 AM

Re: Dr's appointment tomorrow
Are you seeing a doctor on post or off post?

FieryPrincess 04-24-2012 08:15 PM

Re: Dr's appointment tomorrow
I was referred off-post to a civilian specialist because of "treatment options and prognosis"

I would have thought they could handle casts, boots, and braces while doing nothing else on post.

kttyhom9 04-24-2012 08:57 PM

Re: Dr's appointment tomorrow
Going off post may not be a bad idea. You might be getting better care but the way he push you off makes me wonder. You have to stand up for your self when it comes to your health care and the military. After 21 years I learned that lesson really well. Just like I am going to demand a MRI on my foot also since I am have serve pain in it. I don't know why they just did the ankle anyways. I will keep you updated on my appointment on Thursday

Hollywood48 04-25-2012 01:35 AM

Re: Dr's appointment tomorrow
Very good idea on contacting the Spurs!! I hope you are able to get in with them and afford it. It saddens me to hear that our military doesn't have top notch care. If anyone deserves it, they do and I feel they should be able to get whatever they need wherever they need or want it and it shouldn't cost them a penny! With what all they do for us? Please that's the LEAST the government could do, but this isn't the board to get on my soapbox about that. I'm really sorry and i hope you get answers soon. You have nothing besides Motrin for pain?

FieryPrincess 04-25-2012 05:05 AM

Re: Dr's appointment tomorrow
nope. nothing.

As I explained to the Tricare office when I called to find out if I wasn't receiving care of them (they assure me this isn't the case), I have been in pain for 15 weeks and I am gettin' a little cranky about it.

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