Modified Brostrom - See Ya Later, Alligator

Two weeks ago, I had my four-month follow-up appointment with my ankle surgeon after my third surgery on the left ankle.

AND

I am completely released from my ankle surgeon's care.

We're DONE!!!

Granted, the ankle is still a thing, and it'll never be 100%. Case in point, that following Saturday I went to a wedding and danced like an idiot, then this weekend had a big event at work and so now it is a little grumpy, but nothing some ice, aleve, and my wrap brace can't handle.

But I can't tell you how relieved I am after four years and three surgeries to finally be done with this.

Happy Independence Day!

Today was my six-week follow-up appointment after getting the stitches out after my Modified Brostrom surgery. The appointment itself was a pretty quick, he checked the flexibility of my ankle (a little stiff) and we discussed the knee swelling (shouldn't be an issue now that I'm out of the boot) and the game plan for the next six weeks. Here's how it looks:

• Heavy-duty brace (seen in photo) all the time for the next four weeks
• After the first four weeks, transition out of the brace, the wear it when on grass and rough terrain for the foreseeable future
• Physical therapy on my own, unless I feel like I'm not improving

I've been in physical therapy more often than not over the last four years, and "you know the drill at this point. No point in wasting your money on co-pays when they're not going to tell you anything you don't know, and I don't see the need for any physical manipulation at this point." His recommendations were using a theraband to do 12/6s, 9/3s (although not pushing the 9:00 side, as that's where the repair is), as well as doing calf raises, towel toe scrunches, and building up from there. All the stuff I'm used to doing. I will keep you updated!

Keep On Keeping On

Hello Friends,

I'm sorry I haven't given much of an update but at this point, there hasn't really been a whole lot to report. The last month has been one of the more difficult ones I've dealt with in awhile. While I'm still dealing with the headaches and migraines, the most difficult part has been coming to terms with the fact that my family lost my beautiful, vibrant cousin Sarah in a car accident earlier this month. Needless to say, it has not been an easy few weeks, and traveling out to Oregon in a walking boot while using a cane was a bit of an adventure, but it was good to get to spend some time with my family, even if it was for a very sad reason.

On the ankle front, things feel like they're stuck in a holding pattern. I don't have my follow up with the ankle surgeon until the 5th, so at this point am just sort of waiting, clomping around in the walking boot until that point. Hopefully, when I do go back in, I'll be able to gradually start weaning out of the boot, as well as being able to get into physical therapy. I'm pretty frustrated that I haven't been allowed to start that at all this time around, but I understand the need for patience. Sort of.

Over the last week, one of the problems I have encountered as a result of using the walking boot has been swelling and pain in my left knee, the same side as the boot. I know what this is, as it is the same problem I had while using the boot after the first surgery. It is a result of an uneven gait for too long, so I've started using a cane again. It is 100% the last thing I want to do, but it really does help. One recommendation? Be careful how many waterfalls you agree to hike up. Granted, I only went two viewing points above the bridge, but it definitely left me hurting a bit this week. Hard to resist the view, though.

Modified Brostrom Surgery - Return of the Frenemy

I apologize for being a bit slow to update you with my progress following this latest surgery. Unfortunately, I'm still battling this darn migraine on top of the ankle, so  I've been limiting my time on the computer, which seems to aggravate everything. Sorry, but thanks for sticking with me!

On the plus side, the ankle recovery seems to be going smoothly. The first few days immediately post-op were a little rough. I was a little surprised by the initial pain levels, but that was purely my own fault for expecting this to be more in line with the hardware removal, rather than an actual surgical procedure. Silly Jenna. Added to that my stomach's usual disagreement with pain medications and it was a slow start, but once we got a prescription filled to help that out everything settled down quickly.

I spent a very long two weeks and two days stuck on our couch, keeping my ankle elevated and being entertained by the kitty cats. I did a full read-through of my favorite book series (Percy Jackson), watched a few movies, had some great friends stop by and say hello, and took a lot of naps. I'm not a good sit and wait person, so honestly I'm so glad to be back at work and back in the swing of things.

Last Wednesday, I had my first post-surgical follow-up appointment. I didn't see the surgeon himself but saw his PA who I've seen before and like quite a bit. I also met with a student that studying with them for the year, and a nurse who was there to remove my stitches.

After the stitches were out, the student physician and the PA took a look over everything. They were quite happy with the lack of swelling and redness around my incision, but apparently during the surgery, both the anterior talofibular and calcaneofibular ligaments were exceptionally thin. Although they were still able to do the surgery as planned, that did change their post-op a bit. Initially, they thought I'd be in the boot for 2-4 weeks after the splint/cast, but now I get a full six weeks at least. Woohoo.

I'm a little frustrated by that, but after three separate surgeries on this ankle, I'm trying to remind myself that it is better to move slowly and do this correctly than to rush this and risk injuring everything all over again. I'm bummed I won't even be able to touch physical therapy until July, but I guess this is a good opportunity to practice being patient.

Initially, when the student physician came in and talked to me, he said that a lot of people who have had this procedure go into a half boot at this stage, rather than the full walking boot. But upon looking at my surgical notes and the thinness of the ligaments, plus hearing the demands of my job (outdoor historic site, chasing after 4th graders, giving walking tours that cover uneven grounds) they put me back into my old friend/enemy/frenemy, the walking boot. Check out my first, painful little baby steps below. By day two back in the boot my calf had stretched back out enough that I was walking comfortably again, but that first day or so was not super comfortable.

The next morning following my appointment was my first day back to work. And of course, it was an insane chaotic day where we had one 4th grader pass out from heat stroke (because why wouldn't it be 90 degrees in May) and had to deal with a volunteer being exceptionally rude to my new intern (wheeeee), plus just the general chaos that comes with trying to shepherd 75 ten-year-olds around a historic site. According to my Jawbone Up Move activity tracker, I went from taking about 300 steps on Wednesday to taking almost 4,000 on Thursday and 5,200 on Friday.

So, from here, it is really just trying to be patient with myself, not pushing too hard at work, and doing what I can to keep the rest of my body healthy while I wait until July 5th, which is my next appointment. My stamina levels are slowly returning, so after another few days of work I'm going to try heading back to the gym and will start doing some upper body weights. Gotta start somewhere!

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Hello from the other side

I won't write much now as I'm on some pretty serious pain meds and quite exhausted to boot, but today's surgery was very successful. The ligament was very thin, but the doctor was pleasantly surprised by how little scar tissue was in the area. Just goes to show why sticking with a PT who does a lot of hands-on manipulation is a good thing!

Modified Brostrom Ankle Surgery

I got the paperwork for my pre-operative physical, and I now officially know that the name of my surgery next month is a Modified Brostrom surgery. I tried very hard to find all of you some nice anatomical photos so you could see what exactly the surgery is but to no avail. This is the best one I could find.

Journal of Bone & Joint Surgery

As you can see there are different versions of the actual repair itself. I'm not 100% positive which version we will be doing. I will be calling the surgical center tomorrow to try to schedule a time to chat with the anesthesiologist about my migraines, and I will also be asking them for a few more details about this. My surgeon did say he would be borrowing tissue from a neighboring ligament, so perhaps it will be a graft?

In the meantime, I did find a very interesting slide presentation about the Modified Brostrom procedure. If you're not okay with seeing surgical photographs, even fairly mild ones which I would say these are, this link is not for you. But, if that doesn't bother you, it is pretty interesting to see at least one version of this surgery.