I was going to begin this post with a cliche such as "I can't believe it's already been three months," but that isn't exactly true. In some ways it seems like the ankle replacement was so long ago that I am surprised it has only been three months. I've been complaining about my lack of progress, but my doctor and his teaching fellow both said that "I've come a long way, baby!"
The appointment started with x-rays in a variety of stances, including the one above that shows the ankle replacement as well as the arthroplasty or fusion of the heel. When the fellow (I regret that I do not remember her name; she was also present at the operation, but I slept through our introductions) listened to my concern about my progress, she was the first to tell me that the fusion would prolong the recovery time. The swelling of the ankle is evident in the x-ray, but she also said that the inflammation was as expected, and, in fact, it was relatively minor. After answering all the questions I had prepared for the doctor:
- Is my range of motion what would be expected after three months? YES!
- Can I get a pedicure? YES!
- I still have a lot of nerve pain. Is that expected? YES, and I will give you a prescription for gabapentin, a medication used to control seizures as well as nerve pain.
- Can I start water aerobics? YES, you should start exercising, and water aerobics is a great place to start,
- My back and my left foot start to bother me when I walk; would physical therapy help improve my gait? Up until this appointment, Dr. Nunley had said that PT was not warranted. YES, Dr. Nunley will write a prescription for PT.
- I still cannot move my big toe. But, then, I tried, and, for the first time it moved. I could move it back and forth! YIPPEE! My toe is too ugly for a photo, but I can do this now!
Finally, Dr. Nunley entered the examination room. When he asked how I was doing, I told him I danced the hora at my daughter's wedding, albeit for half a minute. At first he said he didn't know what the hora was, but it turns out one of his children married a Jewish person, and he was lifted in the chair during the celebration: he just didn't know the name of this most familiar Jewish tradition.
I took a few steps so he could observe my walking, and he was pleased. Next he examined the primary incision down the ankle; when he started to knead the skin and tissues around the incision, I jumped. That didn't make him happy: he actually -- well, sort of -- yelled at me to stop being so sensitive. He explained that the tissue under the incision can become hard, creating scar tissue. This can be ameliorated through massage. He suggested that I use shea butter or coconut oil in what I have since learned is called scar mobilization. The last time I saw Dr. Nunley he told me to be careful with the incision, not to rub it too hard. Now, he was saying the opposite, almost sounding like I should have been doing this all along. I don't know why some doctors can make me feel inadequate. Tissue under the incision tends to harden and stick together, and by massaging it you can loosen the tissue; coconut oil helps by keeping the skin moist.
I guess coconut oil smells and tastes good to a dog because Zora won't stop licking me after I applied it to my ankle. Afraid it might hurt her, I did a quick google search only to learn that coconut oil is good for a dog's digestion. Some people even put it on their food. It's also good for their coat and skin, although she's not getting nearly enough to make any impact. Perhaps I should try giving her some in her food. She sure likes the taste!
The day after my three-month follow-up I walked a total of 2.7 miles. Three days later I joined a water aerobics class, doing most of the exercises except any that involved jumping, running, or jogging. Instead, I treaded water. The water felt incredible. I may wish I were healing more quickly, but, as the proverb says, "Slow and steady wins the race."
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