My Ankle Fracture Story
My ankle fracture story started with an elegant slip that ended in catastrophe. A fractured ankle is painful both physically and emotionally long after the first six weeks of no weight bearing on the affected leg ends. Life is temporarily put on hold.
Taking a Slip For History
On Wednesday, 24 July 2024 at approximately 10.15am, my left foot slipped while walking on a steep gravelly track on the Mt Pleasant Nature Reserve in Canberra’s inner North. It happened quickly, quietly, and elegantly – a small comfort. My Apple watch didn’t register the fall, I landed in a seated position – no cuts, grazes, scratches or pain – with my ankle in a strange position.
Thankfully I was not by myself. I was with three other history snoops, all of us in our senior years, from the Canberra and Region Heritage Researchers (CRHR), a young ANU archaeologist and a pug dog named Winston.
I knew immediately something serious had happened and despite some encouraging words of “… don’t worry it’s just a bad sprain”, and “… you’d be screaming in agony if it was broken”, I couldn’t bear to put weight on the injured foot. There was no more walking for me that day and for weeks to come. My new friend was a knee scooter.
A Historic Human Chair Lift
The aim of this fateful walk was to show the young archaeologist the site of an old pensioners’ camp CRHR had rediscovered in the gully near Northcott Drive behind the Russell Offices in Canberra. What remains of this camp site has significant heritage value. We believe it evolved from one of the original workers’ camps dating from the national capital’s construction era. Due to our research, the site is now provisionally listed on the ACT Heritage Register.
It is also the area where former NSW police tracker Edgar Spring spent the final years of his life.
Age No Barrier in Rescue Effort
My fearless friends were quick to act after I slipped. Between the young gun archaeologist Stevie, and Trevor (80 yo) and Tony (67 yo) they managed to chair lift me 200 metres back to the summit. No mean feat considering how steep the climb was.
Dave, owner of Winston, offered words of comfort assuring me that I would be screaming if my ankle was broken. Which it was.
What a great video this rescue effort would have made. A great thing to look back on but it was the furthest thing on everyone’s mind during the lift out.
My Ankle Fracture Story in a Hospital Hell
X-rays in the North Canberra Hospital where I first presented showed a closed left fibular fracture and a fracture of the posterior malleolus of the left tibia. The break was serious enough to require surgery in the South Canberra Hospital. So began a nightmare experience of Canberra’s public hospital system.
Waiting for Surgery at the Canberra Hospital
It took four days of fasting for 16 hours a day to finally get the surgery done. I found myself in a dystopian medical hell. I sat with many other trauma victims, in the Day Surgery waiting room. All of us dressed up in gowns, foot coverings and funny hats surrounded by signs warning that aggressive behaviour will not be tolerated in this supercharged, painful and frustrating environment.
Despite the funny hats this was no party. There were only two comfortable lounge chairs in the waiting room. This meant most patients had to be content with sitting on padded bench seats … for hours.
Each day meant a new but same admittance procedure and questions. Name, DOB, address, Medicare number, allergies, past surgeries, GP etc. There was no streamlining or express admission process for returning patients.
On the third afternoon of waiting and being told the surgery wouldn’t be done that day, all a young doctor could offer me was a complaints form. Exhausted, in pain, dehydrated and hungry, I got back on the knee scooter, and rode through the now familiar halls of hell to the main entrance to await my lift home, again.
Knee Scooter Hazards
It was no easy feat manoeuvring the scooter over the new paving at the new main entrance of North Canberra Hospital and then over the rows of tactile ground surface to get into the waiting car.
How I cursed those bumps as the wheels of the scooter hit them putting me off balance and adding to the leg discomfort.
I discovered that these blistered areas are an important infrastructure requirement in public places, first introduced in Japan in 1967, to help visually impaired people safely navigate approaches from path to road.
Surgery and Post Surgery – My Ankle Fracture Story
When I was offered an apple juice around midday on the fourth day of waiting I thought it was a sign that I’d be bumped off the operating list yet again. It was the sign every other day of this nightmare. However, this day was my ‘lucky’ day. A nurse came into the waiting room calling my name and took me to be prepped for what turned out to be a three hour long operation.
Waking In Fright and Plaster – My Ankle Fracture Story
Surgery on the ankle went well, but I woke up in Recovery with a blurry eye. Very scary. It turned out that my right eye was scratched. I thought I would wake up worried about my leg but instead woke up worrying about my eye. Or, if I’d suffered a stroke.
Apparently an abrasion or scratch to the eye is not uncommon during surgery and can happen to dry eye sufferers especially. Perhaps that’s a question that should be asked during surgery admission: “Do you have dry eye syndrome?”, and preventative measures taken. But that’s another story.
Expecting to wake up in a boot, as I was told, I found my leg in a new plaster cast, a choice made by the surgery team because of concern about my skin, probably the age of it.
Nutrition in the Hospital Hell
Arriving back in the Day Surgery ward starving I expected something to eat and drink having fasted since early morning. Not to mention the previous three days. The duty nurse did her best to find me a sandwich but the best she could do were two packets of sweet biscuits and a cup of tea. Hardly satisfying.
After a fitful sleep the breakfast on offer the next morning came in packages, cornflakes, juice, milk, yoghurt, cold toast, fake jam, butter, a plastic cup of tepid water with a tea bag and wooden cutlery. Everything unbreakable and disposable. A complete package of disgrace thrown onto a tray without care.
This is what Canberra Health Services says about nutrition:
“Eating healthy food is an important part of your treatment and care. Good nutrition helps your body heal. It can help you recover faster, prevent loss of muscle and lower the chance of infection.
Our dietitians and chefs create meals that are balanced and nourishing to support your recovery.”
I totally agree that eating healthy food is an important part of your treatment and care and helps your body heal. But my bet is that the food on offer in the Canberra hospital is totally devoid of any nutrition and therefore any health benefit.
And then came the lunch which was no less appetising than breakfast. The crumbed item in the photograph was fish served with steamed and discoloured sweet potato, faded and mushy broccoli and questionable real mashed potato. I doubt the fish was barramundi which is on offer for people who identify as Aboriginal or Torres Strait Islander.
My challenge for the ACT Health Minister, Rachel Stephen-Smith, is to spend a day in a public ward and eat everything that is placed in front of her. I guarantee that by the end of the day she won’t be feeling as good as she did at the beginning of the day.
Ankle Fractures are Complex and Debilitating
An ankle fracture is a complex and debilitating injury one that is misunderstood and underestimated by those who have never experienced it or cared for someone who is suffering the injury.
I felt helpless and my joke that I was training for the Paralympic knee scooter sprint soon wore thin. If I didn’t have a husband who was able to care for me full time, I think I would have needed nursing home care.
An ankle fracture means no weight bearing for six weeks. This means bed rest with the affected leg lying flat or raised and moving around is on crutches or in my case a knee scooter. Thank you, Michael Reid, for inventing the knee scooter. You absolutely deserved the Designer of the Year Award in 1993 for this brilliant innovation.
Life on Hold and Step by Step Recovery in my Ankle Fracture Story
Having your wings clipped is putting it mildly. A broken ankle makes you feel trapped, imprisoned, grounded, disabled, or any word that describes a loss of freedom and independence. Everything feels fractured around you, your ankle, your emotions, your home, your plans. It is depressing.
Step 1 – Six weeks of no weightbearing
Six weeks is a long time. Netflix loses its gloss after a while. There are only so many thriller series you can watch and whodunnits to read while biding the time away with your leg elevated on a pillow. I was fortunate that the Olympic Games was on and then the Paralympics which served as an inspiration and made me feel incredibly grateful that my disability was a temporary one.
At one point I channeled James Stewart, the wheel chair bound character with a broken leg, in Alfred Hitchcock’s ‘Rear Window’ and spent time watching the neighbouring apartment block. As luck would have it, there was no murder to witness.
Fitness Helped Me Manage
It helps to be fit if you fracture an ankle as there is a good deal of hopping and pivoting to do on the good leg moving to and from the scooter either to: the shower seat, toilet seat, chair, lounge, bed or car. Then there is the bending and reaching with multiple contortions. Fortunately I had been doing seniors gym for some 18 months before the fracture and my core body strength was good and held me in good stead.
Everything you need throughout the day (and night) should be within easy reach – laptop, iPhone, iPad, chargers, tissues, disinfectant wipes, sanitiser, water, snacks, medications, ear pods, pens, paper, a bag for rubbish, body and hand cream, the lamp switch and spare pillows and cushions.
Store away floor rugs and move potential obstacles in hallways so you can scoot around your house unimpaired.
Comfort is Key to Getting Through the Day and Night
The Spare Room – New Home
One of the first actions I took when I arrived home after surgery was admit myself to the spare room. Here in the single bed I could thrash about as much as I wanted to find my comfort point without worrying about disturbing my husband. Or, my husband disturbing me.
The Dead Weight Doona
I couldn’t believe how heavy the sheet and doona felt on my bad leg. It was like a lead weight pressing down causing pain and discomfort. Stacking extra pillows sideways so the sheet and doona didn’t press on my bad leg was a good solution. A cardboard box cut out to form a bridge over the leg is also a great way to take the weight of the bedding.
Forget Fashion
Loose and comfortable clothes are imperative. Fashion flies out the door with a fracture. Soft track pants and a comfy top were the way to go.
A Soothing Sheepskin
After a few days propped up in bed I began to wonder if I would end up with a pressure sore. This led me to purchase a luxurious, soothing and comforting sheepskin. It was well worth the expense.
Comfortable Cross Body Bag
After experiencing the straps of a conventional shoulder bag getting tangled in the handles of the scooter, I searched on-line for a cross-body bag. It was a relief to find one at Simplify Living that could hold everything I needed for hospital visits, medical appointments and now shopping.
This bag will be used well into the future. It sits snuggly across my chest and each zippered pocket is conveniently located making keys, cards, prescriptions, lipstick and glasses easily accessible.
Battling the Bruising
The bruising which started to emerge after surgery was extensive and painful. Hirudoid cream rubbed into the accessible areas certainly helped.
Post operative check ups – Cast 1, 2 and 3
The check up I had 10 days after the surgery showed the wound healing well and my skin holding up. I was surprised at the lengthy wound and I felt sorry for my poor leg that looked so battle weary. It was soon placed in another cast for ten days by which time the stitches were ready to be removed.
The Last Cast
The third and last cast came the day the stitches were removed. This time the cast was of fibre glass. With a touch of excitement I could choose a colour from a range that matched the Dulux shop.
Fibreglass casts have advantages over plaster casts, they are lighter and more durable. And these days you can get a waterproof version. However, I was advised not to have the waterproof cast due to my sensitive skin. This advice came, not from the orthopedic doctor, who ordered a waterproof cast, but from the experienced nurse who applied the cast. I could have been in all sorts of bother if this nurse didn’t ask if I had skin issues.
My Ankle Fracture Story and Showering and Bathing on One Leg
Showering was exhausting so I limited it to when I washed my hair every third day. If you have a cast as I did it was essential to keep it dry. I used two plastic bags over the cast and pushed in a soft tea towel around the top as an added precaution against water dripping in. I sealed the bags over my leg with waterproof tape.
I sat in the shower on a chair with the bad leg resting on the scooter out side the shower recess. I never had an issue with water getting on or under the cast.
When you have a fracture you need to get out of the mindset of daily showering a ‘Bird Bath’, ‘Sponge Bath’ or ‘Top and Tail’ is sufficient. I found a simple plastic laundry dish from Bunnings perfect for this purpose.
The Cast is Removed – A Highlight of My Ankle Fracture Story
The big day arrived, six weeks to the day after surgery. I was filled with eager anticipation that my world was going to get easier and more mobile. Out of the cast and into the moon boot.
Step 2 – Four to six weeks of partial weightbearing
Unfortunately life didn’t get that much easier with partial weight bearing. There were different problems to overcome and different areas of pain. In fact, life didn’t change all that much for at least the first three weeks.
I couldn’t ‘walk’ very far or the ankle would swell and hurt. Even more annoying, my back and right leg would become painful. This meant back home to rest and raise the leg with a packet of frozen peas neatly wrapped around the ankle.
Partial weightbearing involved walking in a cumbersome weighty boot with crutches. Thankfully I didn’t have to sleep in it. While I was offered under arm or axillary crutches at the hospital I decided that I would feel more comfortable and less fatigued using elbow or forearm crutches.
I wasn’t prepared for the pain on the ‘good’ side of my body through the legs, hips, back and glutes. I’d experienced sacroiliac joint pain in the past and this pain was identical. This time the cause was easy to figure out.
The moon boot on my left foot was much higher than the trainer I wore on my right foot causing a severe malalignment. I found out too late that you can buy a shoe leveller that allows you to walk on an even platform and helps reduce the strain on your back, hips and good leg.
My Physio gave me a series of exercises to do which helped but I have to say the sacroiliac pain became worse than the ankle injury pain and continued for some time after I ditched the boot after four weeks.
Step 3 – Time to Throw Away the Crutch
It was a relief to know that I could walk without the boot using crutches even though it was painful. But the next big hurdle was walking unaided. I did the ankle exercises religiously and started back at seniors gym with a slightly modified program at 11 weeks. I also started walking around the house without using a crutch.
At 14 weeks when I felt my strength and balance returning I started leaving the crutch at home (in fact, I would forget to take it) and found I could walk unaided with some degree of confidence.
At 16 weeks I feel more confident walking without the crutch but I can’t walk far or fast. I try not to think about when I’ll be able to tackle a walking trail again, or plan an overseas trip that won’t involve a lot of walking.
I continue the daily exercises to improve my ankle flexion and manage on average 5000 steps a day according to the pedometer on my watch. Walking still comes with pain but it is gradually reducing in intensity.
The “Woo Hoo”, will come when all the discomfort goes as one step follows the other at a good pace and I can resume my history snooping on the ground, not the keyboard.
Mind Games in the Story of my Ankle Fracture
Despite knowing that my disability was temporary it didn’t stop me thinking if I would ever walk normally again unaided. The simple action of putting one foot in front of the other and moving forward seemed like an impossible dream when I was hobbling around in a boot with crutches.
If this sounds like catastrophising, it is. The question of having a permanent mobility issue is forever on my mind during recovery. Even now as I walk without a crutch, my gait is not as it was. My iPhone sent a message as I write saying I was walking unsteadily and that I was at an elevated risk of falling in the next 12 months. Thank you phone for the tip off.
Big Emotional Impact
I’m not the only person to catastrophise and worry about the future after an ankle fracture. I came across a study on the Life impact of ankle fractures: Qualitative analysis of patient and clinician experiences by Steven McPhail (et al) where participants not only suffered on the physical level with pain and discomfort but were also impacted by a range of psychological and emotional issues during their recovery including: depression, anxiety, frustration and tiredness or fatigue.
Reading this report was helpful because it validated what I was experiencing especially at the emotional level. I also realised that I’m actually fortunate being 71 and retired. I don’t have the pressure of getting back to work to pay a mortgage like some of the participants in the McPhail study.
You can’t recover from an ankle fracture alone. I was fortunate to have great family and friends support and also a great physiotherapist and sports physiologist at Sports Tec Clinic who guided me and helped build my confidence, strength and balance to walk again unaided 15 weeks after surgery.
