New Ankle New Me

The Big Day.

Every hospital has its own admission procedure. At RNOH I was asked to arrive at 7am. This is so that the surgeon and the anaesthetist can see you before they embark on their day in the operating theatre.

I was taken straight to the ward and allocated my bed. The nurse took some tests, blood pressure, temperature, oxygen saturation and asked a number of questions regarding my general health. I was told my number on the list – 6^th. At this point I was nil by mouth. The surgeon’s registrar came to see me, confirmed the detail of the operation, went through and got me to sign a consent form and drew a nice big black arrow on the leg to be operated on pointing down towards the offending ankle. The anaesthetist came next. He asked a number of general health questions, checked that I had no loose teeth and asked me to open my mouth wide. I explained that I suffer with motion sickness and asked for some anti-sickness drugs to be given to me.

There followed a very long, hungry, thirsty wait. I was finally asked to change into a theatre gown and taken in my bed to the operating theatre at around 4 pm.

I was wheeled into a small room where I was greeted by the anaesthetist and his team. A few monitors were stuck to my body, a blood pressure cuff put on my arm and a line inserted into the back of my hand. All this while the team happily chatted away to me. And then I woke up!

Now I’d like to be able at this point to reassure you that I woke up feeling really good with minimal pain. But I’d be lying. The nerve block I had been given during the operation hadn’t been effective so I was in pain when I came round. However this is not unexpected and the team in recovery are used to dealing with this. I was quickly given intravenous pain relief and a morphine pump was put in place enabling me to administer as and when I felt then need. I returned to the ward around 8pm and was carefully monitored throughout the night by the nursing staff.

Having had a pretty rough time with pain I was kept in hospital for another night and started on a routine of oral pain relief, slow release morphine and fast acting morphine. This kept me quite comfortable. I had a visit from the physiotherapist to assess my competence on crutches and arrangement for my care at home. The registrar came to see me and explain how the operation had gone. I was introduced to blood thinning injections which I was going to have to continue with at home.

After two nights on hospital I felt ready to leave. I was discharged with all the medications I would need including a carrier bag full on injections. I have no complaints at all about the care I received in hospital but it felt good to be going home.

The procedure I had used the Infinity implant with the Prophecy custom guide system or Prophecy Infinity. For a video animation of this amazing operation please see https://www.youtube.com/watch?v=2VGAceOy330

Preparing for your hospital stay.

You’re likely to be in hospital for at least one or two nights. This is going to be dependent on you, how you recover from surgery and what levels of pain relief you will require. So it’s a good idea to clear the decks as it were before you go in. Although it’s a fairly short stay, when you come home you will need to rest. You will have had major surgery and will be on some fairly substantial pain relief. Try to plan it so that you can spend the next two weeks doing nothing of any importance.

You will be given advice regarding preparing for your hospital stay, when to eat and drink before surgery, what to bring with you. Here’s my little extras list:

Phone, charger and headphones. Most hospitals have Wi-Fi now. I used my phone to keep in touch, read the news, listen to the radio etc.

Something to read. A Kindle or IPad, book or magazine. I also bought in a colouring book and pencils, a completely new idea to me but there are some really good grown up colouring books out there which are excellent for giving you something to occupy your time whilst ensuring that you are resting.

Wet wipes and tissues.

And finally, you’ll be going home in a cast. Those skinny jeans won’t go over it! A pair of comfy shorts for the journey home and a sturdy, flat shoe or trainer will see you home in comfort. Also ask whoever is collecting you to bring a couple of pillows along. I found the journey home on the back seat of the car, with a pillow behind me and one on the seat to put my new ankle on the most comfortable way, in fact I slept all the way home!

Preparing for surgery.

Make no mistake Total Ankle Replacement is major surgery. Not only are they inserting a shiny new ankle but a sizable chunk of bone will be removed. The recovery isn’t going to be quick. It’s more complex than a hip or a knee. The ankle takes a massive amount of stress through it. Being prepared for this and giving your new ankle the best chance possible is a really good idea.

So what can you do to help yourself?

Get in the best shape possible. You should know by now that excess weight is not your best friend. Hips, knees and ankles affected by arthritis benefit from less weight being put through them, so, apart from the usual health benefits we are all aware of, the less weight you put through your new ankle the better. You want this ankle to last. Ideally this will be your last ankle operation; you have a role to play in this.

Now obviously it’s hard to exercise when you can’t even go out for a walk right? And I was in a walker boot with a stress fracture now. Golf was out and initially I was uneasy about the fracture and swimming. My solution was the gym. I reasoned that any exercise would have to be done seated and most gyms have a full selection of resistance equipment at which I could happily sit and moves weights around.

Now I realise that the thought of going to the gym where everybody will be slim, muscular, fit and gorgeous is a scary idea. But the reality is actually quite different. Gym goers come in all shapes and sizes. Sure there are some like I have already described but guess what? Normal people use gyms: Old; Young; Fat; Thin. They are all there. I’m actually going to repeat this point: NORMAL PEOPLE USE GYMS.

So I started using the gym. Now back to crutches. When you have had your op you will be non-weight bearing for a while at least. Crutches are hard work. They require upper body strength. At the gym I could only do upper body work. Leg day never came. I was getting plenty of practice on crutches (lucky me) but I was also building up my strength generally and this was going to pay off. Although I wasn’t able to do any cardio work I was able to push myself with weights. Another thing that happened was that I started meeting new people. In fact I was approached on a few occasions by people saying how much they admired me for going to the gym despite being in a walker boot. This gym lark could become addictive! I found that even though sometimes I had to force myself to go (alright most times…), afterwards I felt good for it. The net result was that despite giving up golf and hardly swimming at all I managed to keep my weight steady and improved my muscle tone significantly.

I’m not telling you that you must follow me into the gym but I am saying that there is often something else that you can do when you are unable to do what you used to take for granted. Investing in your health and strength at any time is good but you now have the responsibility of a new ankle to look after. A second chance maybe. Make the most of it.