Apropos of Nothing: Recovery from crippling injury

So, it’s two weeks post-op. The procedure apparently went as well as it could go, I guess – information hasn’t been terribly forthcoming. They put in five surgical stainless screws (the phrase “living tissue over metal endoskeleton?” Yeah, it’s come up.) to affix the broken pieces of the calcaneus (heel bone) back together.

Key questions I had sorta-answered today:

  • It will be another month before I am to start weight-bearing exercises, and I expect those to be light
  • Real activity must wait until three months post-op
  • Full remodeling can take as much as a year
  • I can expect to develop arthritis in the area in a bad way, likely leading to a bone fusion later in life. This cannot be good. 

A lot of orthopedics seems to be a bit of a bailing wire and duct tape approach – we’ll “fix” it now, but you’re going to have to come back for even more surgery later. Sorry about that. They’re very cagey about what activities I can do or not do, probably for liability reasons.

I ran into that when I blew out a few discs in my neck, too. Asking about martial arts after rehab was over, the answers were all wishy-washy. Look, just tell me the risks and percentages, and I’ll make the call. I get that.

So. Back to the heel.

The incision was revealed for the first time for me. I forgot to take a picture of it, and now it’s under steri-strips. But it’s wide. I mean like 1/4″ wide. I think they actually made a 3″ long, 1/4″ wide U-shaped incision and peeled back the skin, to give maximum access. There’s another smaller incision, this one much more precise, a bit farther away. I suspect that was just to put in one more screw.

The swelling is down, believe it or not, and now that I can access the foot directly, I can massage the not-cut-on bits to help move some of that dried blood out of there. The ability to rub your own feet? That’s a surprisingly important thing.

I’ve been given mobility exercises for the ankle, too. Up/down motions, a few times per day, as well as side to side and inside/outside circles. I should probably do them about three times per day, which I will do.

The Boot, The Boot, the Boot is on fire

They’ve put me in a “fracture boot” for the next month. As noted in a prior comment (perhaps on facebook), I thought before that surely nothing could be worse than the cast in term of comfort.

I was wrong.

This thing is awful.

Now, bear in mind, for its intended purpose, which is a walking boot, it’s probably the right thing. But also bear in mind that I’m not allowed to bear weight on my foot for another 1-2 months. The boot, in my case, has three design goals

  • Keep the foot at a right angle
  • Be removable to allow me to do my mobility exercises
  • Protect the heel from incidental contact
So basically, it’s a rigid deflector shield that needs to come on and off.
In exchange for these things, what are the issues?
  • It’s much, much larger than the cast it replaced. This doesn’t seem like much. Until you bump it into things because your foot is now the outer dimensions of a shoebox. Or you try and get into a car, and can’t maneuver the foot into the driver’s side.
  • It’s much heavier than the cast it replaced. This manifests in some subtle ways. When crutching, one has to be very conscious of where it is, or else it’ll bounce on the ground, upset your momentum, and throw you to the floor. When sleeping – or more properly, making a futile attempt at sleep, the vast weight and bulk of this thing is like always being put in a joint lock. It twists your knee either to the inside or outside, and it’s very difficult to get to sleep. When sleeping, if you shift, the inertia of this concrete block can cause some surprisingly painful yanks. Which of course, wakes you up.
  • It is surprisingly hard to adjust to fit. This thing is a monster, but that’s not all. Once you force your heel into the bottom of the thing, it’s a rather involved procedure to get it put back together. First you have to work (ow) to push your heel into the bottom of the boot. Then you fold up a few padded flaps in the toe. Then you put on the outer plastic shell – but careful! The lower part goes inside the strap, the upper goes outside, and then you reach down to secure the three velcro straps. Then you have to inflate the thing in four different tubes. 
Again, what do I need? I need protection, the correct angle, and the ability to remove it.
This is clearly a case of “we have a million of these boots, so we’re going to use them.”
So I’m going to put my cosplay skills to use. I will probably whip something up with Aquaplast, but I’ll want to find larger sheets than 9×12″ for my needs. I suspect two sheets of 12×24″ would be about right. 
I’ll cut top and bottom pieces using a paper blank modeled from my good leg, but mirrored. Then probably mold them over my body, and then attach some padding on the inside, and velcro straps from the outside. It’ll give me removability, keep the foot at 90 degrees, and with the padding, it’ll stand off the heel by the size of the pad, providing both rigid protection and some shock absorbing capability.
And since the boot I’m wearing is already putting my foot to sleep because it’s too tight on the arch . . . this can’t come too soon.
They, of course, wouldn’t approve for liability reasons. A pox on their house – I need to sleep, and the boot is ridiculously overdesigned for the purpose I need it for over the next 4-8 weeks. The splint will be lighter, more convenient, and serve the needs better.
I end with more pix of the foot.

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