Guess who needs reconstructive ankle surgery?

So here's the deal: I had this horrible left ankle fracture when I was 16. The bone was snapped in half and had to be screwed back together. (They removed the screws later.) It's always hurt when it rained and that kind of thing, which I figured was par for the course. Lately, as I've documented here, it has been giving out more and more frequently. I can just be walking along, minding my own business, and it goes over to the side without a warning. Working out on it or a moderate amount of walking causes pain and swelling. Everything hurts it, even just walking around the grocery store. It is one of the reasons I've pursued bariatric surgery with the degree of purpose I have in the past few months.

Back in 1985, when this bone was broken, the orthopedic surgeon just repaired the bones involved--that's what they did back then. They didn't have the technology then to see ligaments or even consider them a problem. I was really young and they probably thought I'd heal up just fine. My ligaments--the ones that provide necessary stability--have long since been shredded. The doctor could tell just by moving my ankle around with his hands that the ligaments there were basically gone and done for; the right ankle, on the other hand, felt just as it should. The difference was obvious in the movement and feeling, especially once it was pointed out and demonstrated to me this way. He said when the bad ankle just gives out now, it's just tearing at existing scar tissue, and the reason I can (thus far) still limp away on my own afterward is because of that scar tissue, but it will still need to be stabilized in a more permanent fashion. Future stabilization = not optional.

Reviewing x-rays taken today, the doctor said, "See now, your bones look gorgeous." (Not a sentence I ever expected to hear...)He could see on the film where the break had been with his practiced eye--right in the ball on the outside.

He said I will have to get this ankle repaired. Not necessarily today, but as soon as I can. It isn't going to get any better on its own, no matter what kind of strength training or exercises I do, and I'm "young" (ha!) and have a long way to go. "You had to know this was coming," he said. Well, yeah, I was afraid it was, but am still "young" (ha HA!) and stupid enough to think that maybe it would fix itself with my eventual weight loss, et. al. Pfffft. What they do is take part of my tendon and reconstruct the stability-providing ligament. I can't walk on it for at least three weeks, but I am allowed to drive an automatic. It's in and out of hospital the same day, no stay. After about a year's time, there is usually a lot of progress that has been made.

So--he said this, and I freaking knew it--walking is no good for me. The ankle can go over at any time--gravel road, crack in the sidewalk, step in a puddle, on a rock, off a curb. The elliptical is no good because you push off from your heel and that can also exacerbate things. Same with the Stairmaster. Since you are usually watching TV or listening to music to provide distraction from the exercise, you're all that much more likely to forget exactly how to compensate for the instability and go boom. I knew this too. Despite the crappy news that I do need surgery, it certainly felt fantastic to be validated. A doctor who listens! We talked about my pending bariatric surgery; he knows my surgeon. He encouraged me to "take care of me first", get stabilized from the GBP, and come in, maybe this fall, and get this taken care of, giving him about a month's leeway. He will write the necessary letters for me and fax his findings from today to my exercise physiologist and bariatric surgeon.

He also said these magic words: "Your weight has nothing to do with this. It is neither here nor there." I wanted to give him a big old hug, kind of like I want to hug the occasional (myopic) cashier who cards me when I buy Mr. Salted's beer at the grocery store. Oh hell, I wanted to kiss him on the mouth, just like a big old grateful hound. Why, thank you, universe! You have dealt me a doctor with a clue!

The bad news is: this puts me out of commission for longer, and I don't know how we will afford it. We'll manage somehow, I'm sure. I don't see what good waiting any longer to fix the ankle would do--it would just mean I had to take time off from a new job (should I be able to find one), and in the meantime, the ankle can still go out whenever it wants to. And it means no school, at least not this year, but I had pretty much given up on that, at least for this year. Maybe the economy will rebound a little by fall 2010.