Tibial Plateau Fracture Recovery Part Four: Learning to Walk Again

August 1st, 2017 I was released to 50% WB (weight bearing) by my orthopedic surgeon. He didn’t give me any other instructions other than handing me another prescription for 6 more weeks of physical therapy 3x/week. He said he would see me again in 7 more weeks.  By this time I had more than researched my break and recovery timetable and knew even when I was released to FWB (full weight bearing) that I wouldn’t just toss the crutches aside and continue on with life as I had known it before this traumatic injury.

Turns out, I had to teach myself how to walk again. And when I say I had to teach myself, I literally mean I HAD TO TEACH MYSELF. Sure, I went to my physical therapy visit 1x/weekly, but my therapist never worked on teaching me how to walk again. It’s not that he wouldn’t have if I wanted him to. He just didn’t need to because I was so diligent about learning on my own. I always seemed to be ahead of myself in physical therapy because I would research stuff at home and work so hard in between my PT sessions. I’m convinced that is why he only wanted to see me once a week. Did I mention that I hated PT.  But I showed up anyway!

Talk about another downer. Sure, I was happy to be on my way to walking at 8 weeks postop, but when I left my surgeons office that day, I started counting the weeks until my next appointment and realized I would be at 50% WB for almost as long as I had been NWB (non weight bearing.)  Cue those tears again. Why couldn’t I just be happy with what I was given?

The ol’ boyfriend had to give me yet another pep talk. “Hon, you have a lot of muscle building that you need to do. Use this time to get your leg stronger so when you’re released to walk it will be no big deal. Focus on the here and now.” As much as I hated to admit that, and the need to stop acting like a 2 year old, I knew he was right.

Basically 50% WB meant I could stand and equally distribute my weight, but while walking on crutches I couldn’t put more than half my body weight into my injured leg. So began my more intense physical therapy and weight bearing exercises.  I did a lot lot of water therapy in those early weeks. Walking felt so good in water. My boyfriend would come home from work and we would head down to our condo pool and he would help me with my exercises.

I also did a lot more crutching around inside and outside the house to build up my stamina. I would put just enough weight through my injured leg and walk heel to toe then follow through with my good leg. My outings were also starting to pick up as well and I focused all my energy on building my leg muscles. Don’t get me wrong, the time still went slow, but a hell of a lot quicker than when I was stuck on the couch in those early postoperative days and weeks.

I suffered a lot of foot and ankle pain in those early weight bearing days. Go figure. That’s because nothing was in use for weeks and you would be surprised at how fast all your muscles atrophy from the chest down in just a matter of several days of non use. I had to work on regaining and using all my muscles. I also suffered a lot of lower back pain. Your gait tends to get thrown off and wonky when you walk with a limp. At 50 years of the age, the old hips aren’t what they used to be either.

My scars were also healing nicely and muscle was starting to build on my leg.

In between weeks, I would sneak a few steps in here and there just to see if I could walk on my own without any crutches. I had to will myself to take a step with my injured leg. It was so heavy. I literally walked like Herman Munster with my arms outstretched and it felt more like I was dragging my leg instead of walking.

I do wish I would have videoed some of those first awful steps. Of course, I cried because I wanted to just go back to my normal walk. It was so frustrating. I would only try a few steps, because I knew I wasn’t released to full weight bearing yet. The urge was too strong not to test the waters, but I didn’t want to risk more damage. I know my body and it’s limitations.

Then September 10th Hurricane Irma showed up. It was also around this time that I noticed a red spot on my shin about the size of quarter. It wasn’t raised, and it didn’t look like a mosquito bite. I was so paranoid of anything that showed up on my leg or scar. I was terrified of infection. Of course I googled the hell out of flesh eating staph infection, and I was convinced that’s what it was. I knew if it grew over the next few hours, that I was probably a goner. Luckily, I woke up the next morning and my flesh was still intact.

I still had no clue what it was. Then one day I got out of the shower and was putting on lotion and noticed in the mirror a large red spot on the side of my left breast. What in the actual f*ck was going on? Was I having an allergic reaction to the metal in my leg? It finally dawned on me that I had been taking a Glucosamine Chondroitin supplement and I thought as rare as it was, maybe I was having an allergic reaction to that. I stopped taking it and kept an eye on the spots.

As if the Universe hadn’t played enough cruel jokes on me, I guess it still wasn’t finished. The spots continued to appear but came with a vengeance on my trunk and back area. Even with stopping the supplement. I finally called my primary care doctor and went in to get it checked.

The first question he asked me was “How did it start?”

” Well, I noticed a red spot on my leg that wouldn’t go away.” He looked at the spot on my lower shin and then examined my trunk area. It couldn’t have been more than 20 seconds and he said matter of factly, “Get dressed and meet me in my office. I know what this is. Don’t worry, you’re not having a reaction to your hardware. We’ll get you all fixed up.”

I went into his office and sat down. He said to me, “You have all the classic symptoms of Pityriasis Rosea. The spot on your leg is called a Herald patch which is classic of this rash.  I’m going to give you a steroid injection today and put you on a Medrol Dose Pak. It should clear up after that.” He wrote the name down for me and told me to google it when I got home. Ha! As if I weren’t going to google the piss out of it had he not told me to.

While he was writing out my script I asked him, “How do you think I got this? Is it contagious?” He said it was viral and wasn’t contagious and it’s a very common rash. News to me. I’m a registered nurse and have never heard of it before.

I was trying to hold back tears, but they flowed so easily these days. “What’s wrong? You seem to be very upset?” I replied, “I’ve just been through a very traumatic injury and surgery and I’m very emotional and under a lot of stress.” He once again reassured me that the rash was going to clear up and to come back if it didn’t and we would do more testing.

I began the steroid dose pack and within a few days, I noticed a difference, but that ugly rash took several more weeks to completely clear up. To this day, I still don’t know how I contracted it if they say it’s not contagious. I did research it and I read that sometimes before the “herald patch” appears that cold like symptoms appear. I do remember having a slight sore throat for a day and a very runny nose for a couple of days. Then a week or so later the red patch appeared on my leg. The only thing I could think of, is that my immune system was so run down from using all it’s resources to heal my fracture that it didn’t have anything left in the tank to fend off a viral rash. I had been in and out of hospitals and my doctor’s office which was also located in the hospital. I likely picked up the virus along my infirmary travels. Thanks immune system!

Finally, September 19th rolled around and I went back for my 15 week postoperative visit and I had another set of x-rays taken.

The x-rays on the left were my x-rays when I was released to 50% weight bearing. The images on right were taken October 31st. I forgot to ask for my images at this particular visit. My surgeon said my fracture was healed and I could “lose the crutches.” You never saw a woman smile so big as I did that day. I wanted to jump off the table and hug my surgeon. He said he would see me again on Halloween. I also was released to go back to my office 2 days a week and work 3 days from home.

Once I walked out his office door, I literally walked to our car without my crutches. It wasn’t a fluid walk by any means and I had a pronounced limp but I was able to walk none the less. Looking back to how disappointed I was when I was first released to 50% WB, I could now understand the reasoning. All that time in-between allowed me to build muscle and stamina.

I bought a cane and would go between that and one crutch for the next week. I also returned to work the next week and used my cane at work those first 2 days back. After that, I was able to walk unassisted. It felt so good to be free again. And I could double fist a coffee in one hand and an orange juice in the other in the morning and walk at the same time. Oh happy day!

I worked the next several weeks on my limp and stamina. The more I was able to walk, the faster  time seemed to go again. Week by week my foot and ankle pain lessened. Walking wasn’t without pain either. It’s very uncomfortable walking with metal in your leg, but I was so grateful to have my feet back on the ground again. I also purchased a desk cycle for under my desk so I could rehab my leg while I worked. It took some practice but I got proficient at cycling while typing. I also keep a stool under my desk to put my leg on when it’s tired or to keep swelling at bay.

By the time my next appointment rolled around on Halloween I had been discharged from physical therapy and my doctor said everything looked great and was completely healed. I told him I have a lot of discomfort from my hardware when I walk, and he said we could take out the hardware in one year and we would discuss it at my next visit in April 2018. He released me to go back to work 4 days a week and work one day from home.

I guess that brings us to present date. I still have a slight limp and it’s more pronounced as the day goes on or if I overdo walking or other activities. I have found a happy medium through trial and error. In addition to using a cycle at work, I exercise my leg in the mornings when I get up. I walk several times a week around my block. Some days we will take a drive to the beach so I can work different muscles and also work on my gait walking on the sand. The ocean and sunshine are an added bonus.  My leg still gets sore when I walk, and I’m hoping that will improve in the next several months. It has already improved compared to when I first began walking.

I can go up and down stairs, but it’s not fluid. Some days I’m just too tired and still go up and down one foot at a time instead of alternating. As my leg strengthens more, I am working on that. I still can’t run, but try from time to time. I never was much of a runner as far as running as a mode of exercise, but I would like to be able to run from danger…or a bee! I do think that will come in time.

And just in case you haven’t seen enough overhead photos of my legs, here is one more.  My fractured knee is starting to look more like my other.  My ankle/foot pain and swelling have finally subsided. I still suffer from ankle swelling from time to time. Nothing a little R.I.C. E. won’t fix! (rest, ice, compression, elevation.)

I do suffer from constant knee pain with walking. < Insert sarcastic chuckle and eye roll here > Walking just isn’t comfortable with a shit ton of metal in your knee. If you look closely at the photo below you can see my herald patch that decided to hang around for the holidays!

This injury remains a part time job. It’s the first thing I think about when my feet hit the floor in the morning and the last thing I think about before drifting off to sleep. I will tell you that every morning the second my feet hit the ground, I say a prayer of gratitude. That, I won’t ever forget to do. We don’t realize how we take our bodies for granted until we aren’t able to use them. Walking is something I will never take for granted again!

This has certainly been a journey, and it is by no means over yet, but at this stage I am fairly active and doing just about everything I did before my injury. Again, not with ease or without pain and discomfort, but I’m so grateful to be among the living again and contributing to society and home chores again.

I will update my progress from time to time. I do hope to get back to some normalcy in my life and some new recipe posts. With the holiday baking season upon us, that should be easy to do.

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