What I did for my winter vacation

From: Ken Poulton (poulton@zonker.hpl.hp.com-DeleteThis)
Date: Mon Apr 27 1998 - 03:55:45 PDT

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Date: Mon, 27 Apr 1998 03:55:45 -0700 (PDT)
From: Ken Poulton <poulton@zonker.hpl.hp.com-DeleteThis>
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Subject: What I did for my winter vacation
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"Now is the winter of our discontent" -- Richard III, Act I, Scene1, Line 1


Surgery (Oct 7) took 2 1/2 hours. The doctor put four screws in the fibula
(small leg bone). The inside ankle bone break turned out to have lots
of small pieces; he put in two pins and a screw and wound some wire
around them to hold the pieces in place. And then he found that I tore
a ligament, so I got a 2-inch screw through both tibia and fibula to
hold them in place while the ligament heals.

I'll be in casts for a total of 8 weeks. The big screw comes out two
weeks later; they guess about two months of rehabilitation. On the
other hardware, my doctor says the ankle-bone wire and stuff will
probably be uncomfortable and suggests taking it out about two months
later. And the screws on the other side will probably be temperature
sensitive, so I may want those out, too.


First cast: 0-2 weeks. I was home for a week and a few days. My leg
was *very* sensitive to elevation - it would start to hurt a lot about
a minute after I put it down. I spent a lot of time taking up Kate's
place on the couch - bad idea for marital harmony. And once I started
driving, I had to take her car since mine is a manual. Sleeping
required elevating the cast to *just* the right position to be
comfortable enough and sleeping on Kate's side of the bed. When Dr
Hewett took this cast off, he yanked out the staples used to close the
surgical incisions. Ouch!

2nd cast: 2-6 weeks. Still quite sensitive to elevation - I spent a lot
of time with my cast on the desk next to my keyboard. There was enough
swelling and pain at the ankle bone that I had them cut a hole in the
cast to relieve the pressure there. Still on crutches. Great crutch
callouses, sore hands.

3rd cast: 6-8 weeks, walking cast: Walking took a fair amount of
"adjustment" of the cast to relieve pressure points around the top and
bottom. It also took me several days to wean myself off the crutches.

After I got the last cast off, it was *harder* to walk. I had only
about 20 degrees of up/down range of motion left, but walking tries
to bend it much more. I actually went back to crutches for a couple
of days to work in slowly.

3 weeks later (Dec 26) I got the big (syndismosis) screw out, and
this helped my range of motion increase. Local anaesthetic, but
they gave me something to make me loopy, so it went by quite quickly.
This surgery only took a day of couch time.

I started physical therapy at the Carr P.T. Center in Palo Alto with
Shad and Kristi - they did a great job. I started with 2 times a week,
and then spread it out as I was able to do more at home. The focus
was mostly on range of motion exercises, with some strengthening
exercises. It took about a month to walk normally, though it
still felt quite stiff. My last appointment about 2 months after the
cast was off - I got to about 55 degrees motion, compared to 75 for my
good ankle.

But the inside ankle bone remained large and uncomfortable and swelled
after any exercise due to the wire over the bone. It bugged me enough
that I got Hewett to take the inside hardware earlier than usual - he
would prefer 8-12 months, but I wanted to be ready to sail in April and
this was not going to be good to sail with. He took it out March 6,
5 months after surgery (this was under general). He was satisfied
with the fusion of the bone fragements, so he took out the two pins
in the ankle bone as well.

Two week later I went mountain biking and my ankle felt *better* the
next day. Halleleuia! The next week I got the stitches out and
the okay to "go for it". I have about 65 degrees range of motion now.

Apr 11: went skiing with my dad and my 10-year-old David, mainly so
David would get to ski at least once this year. Oops. My ankle was
*not* ready to be clamped in a vise. I only lasted about 2 hours due to
soft-tissue pain over the inside ankle bone. But David and Dad quit
soon after because wet snow was coming down very heavily.

------------- 12 Apr 98

Got two new sails through Michael, direct from Windwing: a Windwing 4.4
Air (1-cam/RAF) and a 3.5 Wave (RAF). These mesh with Michael's 4.9 and
3.9 Air sails.

Got 2 430 Wave masts for these sails.

============= Sun 19 Apr 98 - 3rd - 5.4/257 (194#)

First day out on my mended ankle (broken Oct 6) !!

Michael and I rigged Goofy (= usual sizes: 5.4/257 for me and 4.9/8'6"
for Michael (160#) despite it looking kind of light. It turned out to
be real light for what we rigged - Michael could (barely) plane but I
only planed twice and otherwise spent a great deal of time slogging. By
the time I got close to the channel I could see there was no more wind
there (and there was a flood tide) so I just slogged back in downwind
and had a lovely Walk of Shame.

But my ankle felt fine, so I was quite happy.

Jibes: 100% (1/1 :-)

============= Fri 24 Apr 98 - 3rd - 4.7/257 (194#)

The tide was going to make it unsafe at 3rd by 4:30, but luckily the
wind came up early. I got on the water by 2:45 with my 4.7; Kirk put up
5.6 (230#). It was a little light near shore and a little up and
down in the channel, but the 4.7 was just right.

Wind was kind of westerly, so the swell was fairly confused.
This leads to lots of steep faces - great jumping conditions - but
I was trying to avoid jumping while I make sure my ankle is okay.
I really had to work hard at *avoiding* jumps.

It was only my second session of the season, so I was pooped after 90
minutes. Big smiles all around.

============= Sun 26 Apr 98 - 3rd - 6.0/9'1" (194#)

The wind came up late, but I was eager to get some more ebb tide, so I went
anyway. 6.0 looked like it would work with my small board (257), but
by the time I was rigged and dressed (5:00), everyone was hula'ing - not
the time for an 86 liter board. I switched to the 9'1" course slalom
that I usually avoid and was grateful for the extra flotation. Had to
slog most of the way to the channel, but once there I was fine; the wind
even came up a bit by 5:30. Confused swell again, but enough to have
fun on. The dozen or so sailors in the channel had dwindled to 3 by the
time I went in about 6:00.

I had enough wind to plane all the way in, but I ran out of water on the
bar about 100 yards out - there's nothing like a 16" fin in 12" of water
to liven up your day. But I was ready to bail when it happened, so no
harm done other than a little fin sanding.


Today I am still short about 10 degrees of range of motion - I do my
exercises sporadically. My ankle strength is not too bad, but my
balance on my left foot is still a lot worse than on my right (this is
more muscle-related than I would have guessed). The swelling has gone
away, but the ankle bone is still large - apparently this subsides over
time. My ankle often feels a bit stiff, but no longer prevents me from
doing anything.

To summarize: modern medicine is pretty wonderful at making recovery
like this possible, but it's still not all that much fun. In fact, it
hurt a lot longer than I expected. Also, it puts a bit of strain on
your family and coworkers helping you do little things like carry food
to the table all the time. So, overall, I would recommend not breaking
your ankle.

Ken Poulton

"Too fast for comfort,
 Too low to fly,
 Too young to die." -- David Crosby

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