Judith Proctor's Journal

 I just had a horrible shock. The Physiotherapy centre in Broadstone just phoned to say that Manfred no longer works there and would I like to book someone else for my appointment next week?

No, I blooming well don't!

They won't/aren't allowed to say why, but it has to be one of two things - either his mother (who is frail and elderly) in the Netherlands can no longer cope.(though I thought they might have told me if that was the case), or he's fallen out with the new owners of the practice.  It changed hands a couple of months ago.

I'm currently searching the Internet to try and find where he will be working, if he's still in the UK.  He has an inactive Facebook page (but I'm trying to message him just in case he ever checks there ) and I've found a place in Wimborne (local) which has his name on their books - so I've left a message on their answerphone.

Fingers crossed, the man is a miracle worker. Won't give you social chit chat, or run loads of tests - just listens to you saying where it hurts, then proceeds to massage in a totally different place.  And magically, the pain goes away.  Referred pain.  Tension in one area causes pain in another.  I think he just has an incredible knowledge of anatomy, combined with fingers that can detect tight muscles.

Trained at a university in the Netherlands - they must do damn good courses there...

 Apologies for the long hiatus.

As some of you may recollect, I broke two bones in my foot, seven and a half weeks ago.  Which made getting to my desktop computer difficult...  It's in a corner of our office and is hard to reach on crutches, or when you have to shuffle sideways past  a chair to reach it.
I have a tablet, but I normally touch type, which isn't possible on the tablet, so no posting.

Plus, I went down with flu just as the foot started improving.

However, I think I've come out pretty well overall. I can now go on a walk for about 15 mins. I'm tired when I get back, but the foot isn't aching too much.
I can do a little bit of morris dancing - tried for the first time last week. (The physio amazed my by saying I was okay to try step-hops)  I can't cover any distance yet with a step hop, but I did manage to get -badly- through the entirety of two dances.
Went sword dancing last night (which is slightly less demanding on the leg muscles, but requires really good balance for some moves) and had a blast. I chose to walk sedately through a spin move, and sat out of a dance that needed fancy stepping, but still got in a decent number of dances.

Not bad for a 65 year old with mild osteoporosis!

I'm making a note here of things that I think helped me to recover reasonably quickly, in case I break it again.

0.  If you think you have a really bad sprain or a break (I thought it was a sprain originally), then remember RICE

Rest - two of my fellow dances helped me to a chair and I didn't even attempt to put foot to floor.
Ice - A team member managed to locate a frozen drink in the freezer, so we used that to keep the injury as cold as possible.
Compress - Ankle bandage, as soon as possible. Crepe bandages are best, but you can use all kinds of things in a tight corner.
Elevate - We got another chair, put it in front of mine, and rested the foot on that.

Common sense - after checking her insurance was good, another team member drove me home at the end of the evening.

See the doctor!  The doctor diagnosed the fracture and had me off to the fracture clinic the same day.

Post diagnosis...

1.  Be reasonably fit to start with - I morris dance, sword dance, and try to for a daily walk if it isn't raining (that last was difficult this last winter...).

2.  A really useful exercise to do on a daily basis is to stand on one foot for 30 seconds every day. This really improves your sense of balance and also strengthens muscles around the ankle.  I've been doing this for years, and it was on the hospital's list of exercises to do daily once it was safe to put weight on the foot again.  I found it very easy to start up again, and it helps reduce the time between the fracture being healed, and being able to do normal activities again.

3.  Read the information provided by the hospital.  Re-read it at least once a week.  Do what it says!

4.  There are useful things you can do that aren't on the official list - I checked with the hospital fracture clinic (who give their contact email address and phone number so you can ask questions without needing an appointment at the hospital) - things like lying on your back and doing cycling feet, or going swimming, are fine.  Basically, any exercise that is not weight-bearing is likely to be safe in the early phase after an ankle break. The benefit of this kind of thing is that it reduces the risk of muscles atrophying and also helps keep your blood moving while giving your heart and lungs some exercise.
  (I was really surprised to find that I could swim gently for half an hour with hardly any difficulty at all. I was harder to get to the pool on crutches, than it was to swim. I had to use different swimming styles, but basically, it's not about elegance, just about keeping moving.

5.  I found the official walking boot didn't suit me very well.  I used it when outside the house, but indoors, after the first few days, I generally went barefoot and used the crutches.

6.  Never put more weight on the foot then is comfortable.  A mild ache is okay, anything else is not.
I have a tendency to try and overdo things.  This is not good when it comes to broken bones.

7.  Keep moving.  Don't sit down all the time.  It's not good for you.  Even if it's only to lie down and wave your legs in the air, or hobble to the kitchen and back on crutches, try and move a little every half hour or hour.

8.  Keep in touch with your friends - social contact is important. I kept going to dance practice - courtesy of lifts from friends - I just shifted to playing the concertina rather than dancing.

9.  Be married to the most wonderful and helpful man in the world!  (I'm very lucky, and I know it)

 The most irritating thing about moving around on crutches is that you can't carry anything.  

Want to read a book?  The reading part is fine, but I still need a crutch in each hand - fortunately, I am married to a marvellous man who is willing to go and pick things up for me!

I'm making reasonable progress on the foot.  The swelling is going down - probably won't be gone entirely for a couple of months, but it looks a lot better than it did two weeks ago.  I've still got some very interesting coloured bruising, but nothing like the initial balloon.  I've got a large beetroot coloured splotch on the instep which is fairly tender - I suspect there was some muscle damage there, as it's actually more painful than the two fracture points!

The beetroot blotch makes it too painful to wear the support boot, so I've been going around barefoot at home (luckily the hospital physio confirmed this was okay).

Added  few days later..

It's now three weeks since the accident.

My metatarsal is healing slightly slower than predicted, but I think the ankle is healing slightly quicker.  I'm still using the crutches if I'm moving around the room or between rooms, but I can do one or two very basic Tai Chi routines without the crutches. The big advantage of Tai Chi is that all changes in balance are very slow and controlled. Thus, I can control exactly how much weight shifts onto the injured foot.

The most unexpected thing is that I'm sleeping far better than normal.  I have to sleep in a different position than normal in order to have the injured foot on top, but because I'm finally free of the various problems that were causing pain on a pinched nerve in my leg (sciatica type pains have at least three different causes - and I've had all three in turn over the last few years).

Hopefully in a few more weeks, I'll be able to walk through dance moves, but step-hops will probably have to wait a bit longer, as they put far more stress on the joints.

I'm going to attempt what I suspect will be a very short swimming session tomorrow - I did a test run yesterday, so I know I can get up the entrance steps on crutches, use a lift to the lower floor, get my shoes off in the changing room and use crutches to get to the pool.  So, back tomorrow, for the quietest swimming spot of the day (8:30) and we'll see what my body thinks of non-weight bearing exercise that moves the joints in different directions.

I ran both swimming and the Tai Chi past the physio at the hospital - just in case you're worried :)

 I'm actually gaining on all the health problems now. And I promised I'd tell you all what I found helpful.

Realising that the far worse than normal asthma of the last few months was probably due to stress was the key in this case.

Over the course of a couple of weeks, I focused on tai chi, meditation, gentle walks, etc. (and also just telling myself that I was caught in a vicious circle where being unable to breathe was triggering panic attacks which were making the asthma worse, etc.)

The asthma is now back to its normal level for this time of year.

I've still got some remaining stomach pain, but it's not nearly as bad as it was, and googling suggested that IBS was a strong possibility. I've had irritable bowel syndrome before.  It's essentially caused by stress - so no surprise that it's responding to the same treatment I've been giving the asthma.  It always vanishes when I'm dancing... (ie. when I'm happy and distracted)

Things that helped:

1.  Tai Chi, Leia Cohen in particular.  

She has several 5 minute tai chi videos on YouTube - this first one is now upto 13 million views...

I subscribed to her app a year or two ago, and have found many useful videos there.  I use one most days. There are some that are especially helpful with hip problems, great for people who spend too much time sitting down. (helpful for piriformis syndrome too)

2.  Meditation

I use Insight Timer - This site is free and has thousands of guided meditations on many subjects and also relaxation music.  I have the paid version purely becuase it was so massively helpful when I had depression five or six years ago that I would gladly have paid them far more than the annual fee in gratitude. (You get some handy bonuses with the paid version, but the free version is still fantastic)

3.  Dealing with pain

When my sciatica was really bad, I got some help from Curable (I had the operation on my spine not long after, so didn't get to test it on to the full, but I did find it helpful enough that I've kept the app, though I may drop it soon as I've memorised the best bits)

It's essentially a brain-training technique. I read about the technique in New Scientist and went searching for a site that used the technique. In very simple terms, the brain can become conditioned to respond to pain in certain ways.  This means that it sometimes continues to send strong pain signals in situations where they are not helpful.  (phantom limb syndrome is probably the one most people will recognise.)

But the brain can also turn off/reduce pain signals in some situations.  If you're running from a tiger, the pain in your hip is unlikely to stop you...

What the app does is to help you tell the brain which pain signals are too strong. eg.  Sciatica...

I find the 'helpful assistant' on the Curable app to be incredibly annoying, but there are some very good exercises in there and I found them helpful.

 I'm gradually gaining on the bursitis

(I don't think that cut tag worked correctly, can someone remind me how to use them....)

The injection a couple of months  ago in the bursa in my left hip definitely helped.  It meant I could sit down for about half an hour, which was a vast improvement on nothing!

And gradually making further gains.  The big catch was that every time I overdid it (I was able to walk for five or ten mins, which was good, but if I walked too far or tried swimming front crawl as I would normally do with  straight legs, then that could trigger intense pain behind my knee), I lost about three weeks of progress.

I was still having to lie down on the floor cushion for a fair chunk of the day, and to sleep on my right side at night - which means it's no surprise that I eventually developed bursitis in the right hip...

I got a steroid jab in the right hip bursa about a week ago, and that does seem to be helping further.  It's taken about a week for the right hip pain to mostly die down.  He didn't want to do two hips at the same time as that uses a lot more steroids (I already have osteoporosis and steroids are not good for it...)

The effect has only kicked in gradually, but it's definitely there. I suspect the right hip pain was affecting the way I was walking as I've noticed an improvement in the left leg pain even though that didn't get injected this time around. 
Bursitis can cause sciatica. The inflamed bursa presses on the sciatic nerve, causing extreme pain down the leg.

My walking range has now improved to about half an hour.
I'm able to swim more too.  Did 20 minutes earlier in the week. Went for half an hour today, but that turned out to be too much.  It's evening now, and my left hip is still very painful.

it's just a case of finding the balance. More exercise is good overall, but I need to scale it up very gradually.  The long term aim is to be able to drive again, but I don't think I'm ready to try that yet. Car seats are soft and tend to trigger pain quite rapidly.