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'The Bugarin Family Website'

 


Sample ankle x-ray
Before (left) Normal ankle x-ray;
what mine likely looked like before I fell.
After (right) My x-ray after the surgery.

BROKEN ANKLE SAGA

THE BREAK

I was practicing an ice skating maneuver called the "Mohawk". I was not good at it yet, but had accomplished it several times in very inelegant fashion. My final attempt resulted in a fall; my left foot folded under me so that I essentially sat on the inside of my foot. My instructor immediately made me stay down and elevated my injured foot using her jacket.

I lay there on the ice seemingly forever but in reality for a few minutes until the rink manager could retrieve the wheel chair and bring it to me. I do not enjoy being the center of attention, and that aspect of the event was the most bothersome at the moment.
When the wheelchair finally arrived, I was assisted into it and taken to the warmer snack-bar area where the details of the event were recorded. During the recording process, I briefly went into mild shock; my youngest daughter later told me she thought I was sleeping. The shock was short-lived and not un-common for me when I relax following an adrenaline rush. There was surprisingly little pain, even when the skate was removed. I knew it was broken, however, because when I attempted to put on my shoe, my foot moved independently of my leg. top
Since my right foot was uninjured, and I have an automatic transmission, I decided that the most expedient method was to drive myself to emergency. The rink manager wheeled me to my car. I stood on my right foot, twisted my body, and sat in my car. Finally, I swung my legs in; I rested my left leg very gingerly on the floor so the calf was vertical. My two younger daughters ages 11 and 14 were with me at the rink, so they accompanied me to emergency. The 14 year old had lost one of her shoes at the rink, so rather than delaying my departure to look for her shoe, she left with just one. Seems to be a common event for her; we have several pictures of her at various locations with a single shoe on. top
Upon arriving at emergency, I parked the car and sent my daughters after a wheelchair. The intake technician told them to have me pull around to the overhang. I knew the car could not be left there, but it was easier to follow instructions than to argue. Once I pulled to the door, and the technician realized there was no one else to park the car, he changed his mind. I once again parked the car, my daughters brought me a wheelchair, and I entered emergency. top
After completing the initial paperwork, I began to scan the other inhabitants and observed another woman, about my age, in a wheelchair with the same leg elevated and ice on her ankle. I later learned that she had been run over by a tractor - Ouch! All the usual events you would expect took place - I was given an initial exam and quizzed about what happened, what injuries I had, what medications I was taking, allergies, etc. With all that done, I was waiting for the cast I knew I would need and yet another doctor approached. top
This doctor is an Orthopedist and proceeded to tell me that I was scheduled for surgery in the morning and in the meantime, I would have a splint. He also examined my foot to ensure there were no injuries the x-ray didn't show; and informed me that I would be getting a plate and screws. How exciting! - My first broken bone and my first surgery all at the same time. The splint was applied - and virtually useless I should note! I was eventually taken to a room in the surgery ward, where I waited for my surgery. The wait was excruciatingly long - about 20 hours, but eventually I was taken to pre-op. top
The Anesthesiologist came, told me what to expect, and quizzed me about allergies and medications again. I waited again, but finally was wheeled into the operating room; I transferred myself from the gurney to the surgical table, and began to scan the room. The next thing I know, I'm in the recovery room and a nurse is asking how I feel. There was no counting, no "good night", no warning at all (that I recall anyway). top
Shortly thereafter, I was taken back to my room, where a nurse introduced herself, elevated my left foot on several pillows, and asked how my pain was. Rather than a cast, my foot was splinted. The splint however was much more effective and a lot heavier than the original. I went home the following evening; two nights without sleep was plenty! top

THE RECOVERY

April 22, 2009
The only real pain I've had up till today has been from the splint resting on the staples or screw - I'm not sure which. I have gotten the occasional shooting pain, but it always subsides quickly. Today, however, the staples were removed, and that was definitely painful. Once the staples were removed, I got a blue fiberglass cast. The cast is about one-third the weight of the splint, and much more comfortable. While applying the cast, the doctor had to position my foot properly; it felt as if he were pushing my toes into my shin. In reality, the angle was about 90 degrees. top
May 20, 2009
It's six weeks following surgery. I got my cast off today and now I get to wear a walking boot. I'm still not allowed to put weight on my foot for two more weeks, however. The boot weight is roughly the same as the cast, but I can remove it to bathe and to begin flexing my ankle. I am amazed at how my calf has atrophied and how stiff my ankle is. top
May 28, 2009
Physical therapy, umm torture, begins. It's initially limited as I'm still non-weight bearing this week. The first thing he said was that I have to control the swelling by keeping it elevated above my hip and icing it more often. He gave me a length of rubber strapping similar to a very wide rubber band; I'm to use it as a resistance while I flex my foot. I also get to "write" the alphabet in the air with my toes to help improve my flexibility. top
June 23, 2009
At the time of this writing, it has been just over 11 weeks. I've removed the walking boot permanently and my physical "torturist" assures me the range-of-motion will improve more rapidly without it. Progress in regaining my strength has been slow but steady and much as I had anticipated after seeing my calf. The range-of-motion, however, while steady, has been much slower than I expected. I have had frequent bouts of pessimism and spent much time in prayer and Bible reading to counteract the temptation to pity myself. I will do my best to trust that God will allow only the best for me. My desire is to ice skate again as soon as I am able; whether that is in God's plan for me is still a mystery.
I have been working from home since I returned from the hospital; I'm a programmer and as long as I have access to the system, where I'm working is immaterial. My boss has been very gracious and forgiving throughout my recovery and I am grateful for that more than I can express. top
July 1, 2009
Today, I tried on my skates. The left skate was very snug, and the pressure on my ankle hardware was intense. I didn't tie them or attempt to walk. I was greatly disappointed. top
July 13, 2009
As of today, it's been 16 weeks since my injury. My range of motion improvement felt like it had stalled since my last entry until today. I saw improvement once again. Until today, while on the elliptical exercise machine, my left heel would not remain on the foot pedal continuously. Today, however, I was finally able to keep it on the foot pedal the entire stroke. I don't return to PT until Monday (three days hence). I've been doing extra heel stretches in hopes of seeing further improvement. My strength is still improving rather steadily. I was doing heel lifts with both feet together; today, my therapist changed it to both feet on the lift, and the left only on the descent. top
July 16, 2009
There is one screw that bothers me frequently, and I suspect a second will bother me almost as much once the first is removed. So I'm tempted to have those two screws removed, but does the removal of those require the plate to be removed as well? My therapist says they recommend leaving the hardware in unless there's a compelling reason to remove it. He's sympathetic with my dilemma, as he can feel and see the head of the screw that's bothering me. Oddly enough, that screw bothers me most when the swelling is greater; I would have expected the swelling to cushion it some, but not so. I go back to the doctor in two weeks and a couple days for my final check. I will to ask then about what's involved in removing some or all of the hardware on my Fibula. top
July 23, 2009 top
Wow! Today, I saw more improvement in my range-of-motion and my therapist asked if I had skated yet. I've been intending to, but that last time I tried on skates really discouraged me so I keep delaying it. He indicated that as far as he was concerned, I was ready to skate and no longer required physical therapy. We went ahead and scheduled one more session, and I will make sure I try to skate before I see him again. I'm jazzed and frightened at the same time.
What fun to be skating again; July 23, 15 1/2 weeks after falling, I'm finally back on the ice! Thank you, Lord for this magnificent gift! My physical therapist wanted to make today's session my last, but I wanted to get back on the ice first. I scheduled only one session for next week; I'll be out of town most of next week anyway. So, due in part to his suggestion to do so, I went skating. I'm not excited about ending my sessions, but I'm so grateful to be skating again that I'll forgive him. Besides, I knew they had to end sometime. I decided to try the rental skates since the ankles tend to be softer (less supportive) and hopefully would put less pressure on my hardware. Sure enough, I was right. I skated for almost 45 minutes. My left ankle is not as strong as before I broke it, but stronger than when I first started skating. top
August 8, 2009
I went to my last therapy session on the Monday following my first skating session. The swelling was worse than usual since I'd been sewing every free minute and not keeping it elevated or iced, as I should. My therapist was out of town so his partner did my therapy. He asked me how often I ice it. He was very nice about it; but, since I knew better, I felt chastised nonetheless. My final appointment with the doctor was one week later on August 3rd; he seemed impressed that I was able to skate already. We discussed removing some of the hardware; I told him that I was considering removing one or two screws. He told me he would be willing to do that in December. He added that everyone who did have the hardware removed was glad in the end that they had done so. top

HARDWARE REMOVAL

October 19, 2010
I'm scheduled to have the hardware removed from my ankle in November. Dr. Bales requires that I have some tests done first. Today I got an EKG, my first ever, and some lab work. I haven't decided yet whether to remove the two screws in my Tibia. Financially it makes sense to do it at the same time as the other screws, and Dr. Bales said it only adds about 15 minutes to the surgery. I'm not having a problem with those, but that may be because the screws in my fibula bother me so much. top
November 1, 2010
I went in for my pre-op with Dr. Bales this morning. My surgery is scheduled for the 10th. Richard will be out of town, so I'll have to find someone to drive me. I will miss skating in the Oakland competition on December 5h; as a matter of fact, I might still be using crutches then. I can hardly wait to get these out even though it means going through some of the same discomfort again! top
November 9, 2010
My surgery is tomorrow. I decided to test for Pre-Alpha before the surgery and so scheduled that for today. I passed!. Among other skills, I had to do a forward glide on each foot. I intended to glide straight, but got onto the edge on one foot and I was heading for the wall. I didn't want to stop gliding so soon, and I managed to switch edges and curve away from the wall. I've been working on that; but I haven't achieved the same level of accomplishment there that I had before I broke my ankle. My blades badly need sharpening, but I didn't want to risk that just before a competition (Nov 5th) or just before testing without time to get used to them again. So I put off the sharpening until just before my surgery. The blade sharpness or lack thereof didn't have much impact on my test except perhaps that glide. top
November 11, 2010
I had my surgery yesterday and slept most of the day. Once the medications wore off, I think my ankle hurt worse than before or after my first surgery. I actually took one of my prescription pain pills last night. It doesn't help the pain a lot but it helps some and it puts me to sleep so I don't care. I'm already sick of the crutches and I can't wait to bathe without struggling to keep my leg dry. top
November 29, 2010
I got the staples removed today. My ankle looks so skinny now! I can take a normal bath or shower now; that's a relief. Doctor Bales said I can walk if I want to but I have to keep my pace slow and be very carefull to avoid any twisting of my ankle. He said I can start working on my flexibility, and he will prescribe physical therapy if I think I need it. I think I can manage with just what I recall from before. I have a lot more flexibility now than when I got the cast off. top
December 20, 2010
Dr. Bales released me from care today. I can skate again, although I don't intend to do so until January. The ice is too crowded during December and I don't like to skate in a crowd. He said it would probably be a good idea to develop more strength in my ankle before I try skating, and I can use the rest of December to work on that. top
January 2, 2011
I skated today. I decided to wear only the sleeve type gel pad and omit the donut shaped pads that formerly cushioned the screws. The incision is still a little tender, the ice was marginal, but my edges were actually improved. Probably because I had my skates sharpened. top
02-19-2011