Wow, it's harder when you're five years older.

As many of you know, I fell down the stairs five years ago and shattered my left ankle. For those in the biz, it was a bimalleolar fracture with severe syndesmotic disruption, which means that in addition to breaking the ankle, I dislocated it. After five years, the repaired joint had deteriorated so that I could no longer walk without pain and sometimes the ankle would give out completely. I spent 4 months waiting to see THE ankle man of Pittsburgh, Dr. Stephen Conti, and then another 6 weeks to get onto his surgical schedule. I spent that six weeks preparing, having already been through the joys of non-weightbearing and all its limitations five years ago.

We live in a ranch house now, and I was certain that that would make this process simpler, and it has. And instead of hopping around with a wheeled walker, I have a fabulous knee scooter. It's much easier on the body and kinda fun, too.

The next fabulous invention is the cast cover for the shower. Gone are the days of taping a plastic bag to the casted limb (which always leaked to some degree). Today I am using the Duro-med cast cover, an ingenious device with a tight rubber collar and heavy plastic bag for the limb. They are available in long and short, for legs and for arms. I've used it twice so far and my leg has stayed completely dry. There are other types, too, that are disposable, but this is the one recommended by my physician and I went with it.

And of course my toes are hanging out and getting cold. No worries! Welcome the Cast Cozy (available in heavy or light weight). It velcroes right around the foot and keeps your toes toasty

I applaud the wonderful people who made these products!

The surgical experience was also made better by technology. The historic process was to stuff you full of pain meds in the hope that you would not care that your ankle felt as if it were resting under a fully-loaded Mac truck tire. Five years ago I spent 24 hours in a dilaudid-induced haze with pain so intense that I actually had nightmares about it. Narcotics are also bad for those of us with sleep apnea, and they can mess up the intestines, too. The newer thinking makes a lot of sense- insert a skinny, skinny catheter into the area of the main nerve and send a continuous infusion of long-acting local anesthetic to bathe the nerve. It's called a continuous sciatic nerve block and it is amazing. I found out just how amazing it was on Wednesday evening when it either kinked or blocked and stopped working. I was a sweaty, crying, screaming mess. Kudos to the anesthesia resident (from the Acute Pain Service) who managed to unkink it and gave me a huge bolus before hooking it back up.

The medication is contained in a balloon, inside a rubber ball, and it slowly squeezes down until the medication runs out or your doctor has you remove the catheter. Yes, I said, has YOU remove the catheter. Or in my case, it was Ken, who really manned up and took it out on Friday, after it had been in for 48 hours. And once it wore off, I was okay. I had started on some good narcotics and they were on board when the pain kicked in, and it was very tolerable. The ball is called a Q-ball, and you wear it in a little bag around your neck (to keep track. And you become very paranoid about that catheter). You had to see us all lined up in physical therapy with our Q-balls hanging around our necks!

I plan to blog some more about this whole experience. It certainly is better doing this electively rather than traumatically! So stay tuned and I will try not to be too gross as I describe my experience.