Congratulations Brooke and Crystal ICE!

Way to dominate, ladies!
Philadelphia was a blast. It was our first time there. I felt like I too ran a marathon with all of the crutching I did in that city. Thanks to our good friend John for hosting!

Chicken Fried Bacon

They have chicken fried Bacon in Philadelphia.

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Physical Therapy

Yesterday's physical therapy went great. It's located just a few blocks from George Washington University Hospital. My physical therapist is Kim Stepien. We mostly talked about the injury and took measurements of my strength and flexibility. It was a lot of fun explaining the last nine months to her.

The dorsiflexion situation, unsurprisingly, is terrible. My foot is currently stuck at 90 degrees when I try to move it up. You need about 10 to 15 degrees past 90 to walk normally.

My right butt cheek has atrophied pretty bad, so I've been given a few exercises to improve my butt strength. I'm not sure how Kim could tell. By sight? It was probably from the strength tests, but it would be amusing if her assessment was by sight.

I've added quads and hamstring to my workouts in the gym. I might have gone slightly overboard on my ankle today. At the moment, I cannot bear any weight on my foot without copious amounts of pain.

I asked Kim about the popping sounds coming from inside the joint. She said it was actually a good sign. It shows that there is some moderate movement in the joint. I also asked her about some of the pain I'm having, and she said all of the foot pain is good pain.

The next appointment is tomorrow morning and then we're off to Philadelphia for Brooke's marathon this weekend. As a Redskins fan, I'm ashamed to go to this city after what Vick did to us Monday night. I think I'm obligated to wear my Portis jersey, but there's a good chance an unruly Philadelphia fan will punch me in the face. We'll see.

Hilarious Ankle Pain

The ankle and foot pain has been bothering me quite a bit when I move it. I've started to take some of my prescription pain medication at night to help me while I try to rehab my ankle myself, but I only have a few pills left and they're probably too strong. I was hoping use up the rest of my prescription while I went to physical therapy, but it looks like I'll need to contact the doctor's office tomorrow to see what we should do. I'm looking forward to and dreading physical therapy.

I think most of the pain I'm experiencing is "good" pain. I don't have any throbbing pain in my tibia and my fibula pain is very slight. The ankle joint is very rigid and painful. When I stretch it out, I get about 6 or 7 loud pops. Fortunately, I can bear weight relatively pain free if I don't move. Once I get into a walking motion, the pain gets pretty intense.

Now I'll stop whining about my ankle and tell you about the sweet measurements we just did. We took a tape measure to my calves and my bicep. The left calf was 16 inches in diameter. My right bicep is 14. My right calf was 12. Awesome!

The two large holes are healing nicely. It's amazing what a few showers will do for the condition of my skin.

I decided to take a quick video of my flexibility so I could have something for comparison later on in my recovery. Not a whole lot going on yet.

Gross

Today was time to remove the final bandage and reveal the two puncture wounds in my shin. I'll admit, this grossed me out.

I bled quite a bit from these wounds.

The weird thing about puncture wounds is that the heal from the inside out. There's no noticeable scab on top of the holes.

My skin is in great condition.

The skin is so soft, so smooth. I need to sign up for an Aveda ad, or maybe join their institute.

One Red Foot and One Subaru

Today really made me miss how comfortable and effortless it used to be to walk. Since it was my first day back at work, I walked around a lot more than I had at home Wednesday and Thursday. This second attempt at walking for the first time in months is definitely more difficult than the first try earlier this Summer.

My subtalar joint (between the calcaneus and talus) is killing me. This joint was really stiff before the third surgery. Now it feels like my calcaneus bone has been replaced by a set of Cutco Knives. Sorry for the obscure reference, but I almost got fooled by this scam when I was in high school. When they told me I'd have to buy my own knives to sell to people, I realized these people were preying on my stupidity -- something I have in abundance. But man, those knives could cut through a penny, then a rope, then a shoe, and then a tomato!

In comparison, my ankle joint hasn't started to bother me yet. I guess that's a good sign, but I'm sure in a few days I'll be complaining about that, too.

While a doctor may look at my ankle and say there are good things happening here, I look at my ankle and say that there is little right with it. In this picture you can see how the width of my right foot is much smaller than my left foot. It's difficult to see from this picture, but my right foot has a much higher arch. All of the tendons, the connective tissues around the joints, the muscles -- everything is insanely tight. Plus, on top of all of this, I have several puncture wounds to walk on.

I know that after a few weeks of pain my ankle will be in better shape. It would be great to Tivo this part and fast forward through it.

I start physical therapy Wednesday at a new facility, the Center for Orthopedic Rehab and Exercise. While I enjoyed going to Sports Therapy and Rehabilitation Clinic, I had a few concerns going back, so I'm going to try out a new place. We'll see how it goes.

I decided today to pass on attempting to return to snowboarding by Spring 2011. It's more important that I allow my ankle to heal completely before rushing back into the sport that took away most of my 2010.

However, nothing is stopping me from taking a Subaru off of a sweet jump, like this guy did back in 2007. Please, do not tell Brooke. She could actually stop me from doing this. Yes, she no longer reads the blog. She gets enough of my ankle without having to read about it.

There's a sweet video off of that link. I'm surprised none of the snowboarders from that film ended up in two external fixators.

Like A Boss!

Put it in full screen and HD mode to make it seem like you were there.
Thank you, Dr. Buchanan, for making this quick and as painless as possible. I especially appreciated that you left the drill out of the room until it was needed. Nice work.
So how does it feel to have pins pulled and drilled out of your bones? The skinny pins didn't hurt at all. I had hit the external fixator on enough objects over the last three months to make them extremely loose.
However, removing the two threaded pins hurt, especially after they were removed. It still hurts just a bit even a day later.
I'm extremely pleased with opting out of surgery. We would have waited in the hospital for hours for a 5 minute procedure. Then we would have stayed in the hospital for several more hours while I recovered from the anesthetic. This was a much better option.

Look Who's Walking

The video of this morning's procedure is still processing on You Tube. I'll put up the update here when it's ready.

Getting metal pulled through flesh and bone is a unique feeling. I'm looking forward to never going through it again.

Actually, it wasn't that bad. Everyone in the office expected me to take a video. Dr. Buchanan told us that he wore a tie for the occasion. During the procedure he did a great job of narrating the action and, unlike me, kept the commentary interesting.

Dr. Buchanan said he thought there was a good chance his drill would make the blog. He was correct. The drill he used was a wedding present. Earlier in the week he was probably doing repairs around the house with it.

While we're waiting on the video, this is what an ankle looks like after an external fixator is removed from it. I didn't get any pictures of the two giant holes in my shin, unfortunately. That was probably the worst part of the whole deal.

I'm Going To Miss You, Bear Trap

The bear trap gets a new home tomorrow morning at 8AM. I'm actually going to lose quite a bit of my mobility once I start walking again. Not sure if you've heard, but I'm probably the best crutcher with a bear trap on his ankle on the East Coast. Going from awesome at crutching to awful at walking will be a challenging adjustment.

Here are a couple of videos to get yourself prepared for tomorrow's action. I'm hoping that these videos will give me enough instruction to remove one of my pins myself.

Speedflying

As long as you avoid hitting a mountain, this looks like it might be easy on the ankles.

Splinters

I found some splintering action in the tibia just underneath one of the large threaded pins. I'm wondering if this will make removing the pin a little uncomfortable.

The same kind of splintering can occur in wood.

I've had about 30 holes drilled into my bones. I guess splintering was bound to happen.

Top Three

I forgot to mention this. Wednesday, I jokingly asked Dr. Buchanan if I could return to dominating the slopes and avoiding trees this Winter. While he said that was a poor idea, he did suggest that I might be ready as early as Spring.

This is probably what I looked like when I heard there's a chance I could be back on a snowboard by March.

Now I've got to start focusing on getting back in shape. Turns out that if all you do for 10 months is sit on a couch without walking, you become ambiguously shaped, lethargic, and unsuitable for multiple 8-hour days of continuous snowboarding.

That's a slight exaggeration. I have been doing quite a bit of crutching, although the furthest I've gone without rest was three quarters of a mile. Thanks to Phil and Lauren, I'm also the proud owner of one Shake Weight for dudes.

I'll probably need to re-read the chapter about snowboarding safety before I get off of my first chair lift of 2011.

No word from the doctor's office about when the external fixator comes off. I'll call them on Monday to see what's up.

Here are the top three things I enjoyed about wearing an external fixator:

1. 
   
2. 
   
3. 
   

Getting My Heal On

I put this video together to see how the bones have been healing. It turns out my ankle was really deformed in July.
Here are the individual frames from the video.
This was taken in late July.
This was taken in late August.

Yesterday.

I had quite a number of people at work tell me I'm extremely stupid for opting out of the surgery. We'll see. I think I'm going to dominate the procedure.

Can I Borrow Your Drill?

The Orthopaedic Foot and Ankle Center moved to a new building in Falls Church, VA this week, so we got a chance to check out the new digs. It's a great facility. We no longer sit in an exam room that once served as the janitor's closet.

Good news -- it's time to remove the external fixator. The pelvic bone is incorporating nicely into the tibia and the fibula has formed a very awkward but noticeable bridge.

You can make out the bridge in the fibula here. You can also see the pelvic piece sitting in the tibia.

I can't wait to walk on my pelvis. Good chance that's never been said before.

I can't tell if the holes in my fibula are healing. Check out how far the pelvic piece sticks out!

This angle has my leg slightly turned inward. This is about as normal as my ankle has looked since February.

Here's a close up of the bridge.

We asked if that crack was normal. Dr. Buchanan said it was and that we could expect it to be almost completely gone in a few months.

I really like this angle.

So what's the game plan? Originally we were going to do another surgery with light sedation. I asked Dr. Buchanan if we could remove the external fixator in the office. He contemplated it for a moment and agreed.

No surgery. No sedation. No local anesthetic.

It's just me, a drill, some pliers, elbow grease, and a video camera.

I'll take some Valium and Oxycontin before the procedure so I don't cry on camera. I'll be able to bear weight as soon as it's removed.

I'm a little curious as to how this procedure is going to feel. What if one of the pins is especially nasty to remove? Will there be some wiggling to loosen it out? Will it feel amazing?

I'm not concerned about the pain -- it cannot be worse than the initial injury or walking on a broken ankle for several weeks.

It should make for some great video.

We're staying in touch with Dr. Buchanan's office to figure out when the procedure will go down. We're tentatively planning on next Wednesday, but it depends on whether Dr. Buchanan can get all of the parts he needs -- like the drill.

Foam Pit Snowboarding

Who's got a backyard I can borrow? Bonus points if it has a huge hill.



We see the doctor on Wednesday. I'm extremely ready to have this bear trap off of the ankle.