Anklefilter

July 5, 2005 12:47 PM

I broke my ankle on Thursday and am looking for some reassurance from others who have gone through similar surgeries...

I am going to have to have surgery on Friday to put in three screws and a metal place where my ankle is broken. I've never had any sort of surgery before and I am TERRIFIED. I know someone posted recently about being scared of some dental work they were having, but this is different. They are giving me an epidural because I don't want general anesthesia & I'm also terrified of vomiting. I know, I sound like a real freak. What I'd like to know are the following: Has anyone ever had surgery for an ankle fracture? How much does it hurt afterward? I have not been in much pain since they reduced my ankle in the ER. How long were you out of commission after the surgery? Second thing: how much does an epidural hurt? Has anyone ever had an epidural rather than general anesthesia for lower extremity surgery? How was it? Thanks for any experiences you can share!

posted by fabesfaves to health & fitness (16 comments total)

My brother had exactly the same operation a few weeks ago (although he had a GA rather than an epidural). I'll get him on here the next time he hobbles over to his computer.
posted by chrismear at 12:59 PM on July 5, 2005

I've had a similar surgery, on my ankle (I have a dozen screws and a few pins, though, no plates).

I really can't speak for longterm pain, since my break was pretty bad and they keep talking about wanting to "reset" it. However, the surgery wasn't as bad as I expected, and the pain was really manageable when I took the meds. I was off it for about eight, maybe twelve weeks, but my situation was unique. I'd also broken the other ankle, both arms, and both femurs at the time. Were it just the ankle it wouldn't have been nearly so long.

I had a general, though, since I didn't think I could mentally deal with hearing the surgery itself.
posted by Kellydamnit at 1:01 PM on July 5, 2005

Four pins up my tib and fib when I was sixteen, mended perfectly, no pain meds, no anesthesia when they took the pins out (a pair of pliers on the bent ends, and out they slid. Odd, but not bad.) Arthritis now in that ankle but otherwise good as gold; I've ridden in a three-day-event and trekked Cappadocia.
posted by rdc at 1:09 PM on July 5, 2005

As far as surgery in general goes, I had out-patient surgery to fix a hernia a couple years ago. Epidural was not an option; I had the GA. I remember being more than a little concerned I wouldn't pull through the surgery and remember the first thought that entered my mind upon awakening was, "Ah! I didn't die!" I then dozed off, and the next thing I remember they were trying to get me to sit up at which point I started heaving. They gave me medication to control that (apparently, they had already tried that a few times and already gave me medicine, but this was the first time I remember). Once the wretching subsided, I can honestly say the abdominal wound never hurt again (discomfort, sure, but not pain). And the hernia was clearly fixed from that day on.

I know it's tough when you're the one it's being done to, but you'll be a trooper and will pull through fine. Best of luck.
posted by Doohickie at 1:22 PM on July 5, 2005

7 years ago I broke my ankle playing softball. It was a really bad compound fracture that resulted from a collision at home plate - I was the catcher and the guy who ran into me was about 280lb.

They operated on me right away, so I didnt have a whole lot of time to ask questions or be worried about it. General anesthesia, and I had several screws put in on one side and a plate on the outer side going about 6 inches up my leg from my ankle. (The 'plate' looks more like a mini ladder to me).

I was in a hard cast for about 8 weeks and then had a soft removable one for another 8 or so, but my break was pretty bad. The pain afterward was not too bad, but I remember it being a real hassle to get around on crutches (it was the first and so far, the only time). And today it's back to 95% of where it was before I broke it, just feels a little stiff sometimes, but I can ski, bike, etc, with no restrictions.
posted by isotope at 1:23 PM on July 5, 2005

Like I said above, my little bro had this surgery done (screws and plates inside the ankle), and he was 'shit-scared'. He said this to me:

It does seem like the only reason he doesn't want GA is that he's worried about vomiting. I'd say, you shouldn't be allowed to eat for 12 hours in advance, and then, there's nothing to throw up. Unless he's someone who throws up a lot, and easily (like, by sticking his fingers down the back of his throat), it's really unlikely for anything to happen. You get a prick in your hand, then you feel a bit groggy, not in a nauseous way, and not really like being tired, everything just sorta fades out. Then you'll wake up in recovery, maybe with an oxygen mask on. You'll feel groggy for a few hours afterwards.

About the vomiting thing, I think it's because they put a tube down your throat, to help with the breathing. So you have a bit of a sore throat afterwards. But that's about it. Mostly it's just kinda cool.

I think general anaesthetic is great, really. I didn't have any nausea at all, and the residual grogginess meant I didn't feel much pain at all after the surgery. It also means you don't have to have a thing stuck in your back.

The day after the surgery, it was painful, but painful like "I ate way too much food" painful, in your leg. Nothing terrible.

After the surgery, the actual ankle hurt a lot less: the pain was from where they'd made the incision.

He came out of hospital a couple of days later, and he's having the plaster taken off about five weeks after the surgery.
posted by chrismear at 2:01 PM on July 5, 2005

I broke my ankle just about five years ago and had a plate and three screws placed on the fibula and two screws on the tibia. I had general anesthesia, so I was out for the procedure.

I was in a hard cast with crutches for eight weeks, followed by eight weeks in a soft cast with some weight bearing allowed but mostly still on crutches. I then had to wear a soft brace with sneakers for several more weeks while I did physical therapy.

I was off work for two weeks--the first week was spent arranging the surgery and the second week was recuperating from it. My doctor wouldn't put a hard cast on me until about a week after surgery because of the swelling, so although I felt fine a few days after surgery, I wasn't able to return to normal activities until I had a hard cast.

I remember being in pain right after the surgery but that went away once I could buzz the nurses for morphine. Within two days of the surgery, I really didn't need any pain meds. (I was in the hospital for 23 hours, which I think is pretty standard for the surgery.)

It took me awhile (about a year, probably) to feel totally back to normal. I had stiffness in my ankle for awhile; if I spent a lot of time on my feet in a day, my ankle would be swollen and a bit painful by evening. That said, I was back to walking basically normally within three months.

Things that helped me through this time:
A boyfriend who is willing to come over every other day to take out the trash and do laundry.

A water-bath foot massager and reusable ice packs for days when my ankle was really swollen.

A small tote bag that I could attach to my crutches so I could move items.

Water bottles with tight lids for transporting beverages in my tote bag.

The really hideous recliner my mom bought for me for elevating my foot.

A bath stool (try a medical supply house or the hospital may be able to get one for you) and handheld shower head for bathing. (I tried the tape and garbage bag combo recommended by my doc but found sitting on the chair and sticking my leg outside the tub worked best for showering.)

An office chair on wheels so I could roll myself around when I was feeling lazy.

A small footstool at work for keeping my leg elevated.

When I broke my leg, I lived on the third floor of a walk-up and took public transportation to work every day. So the broken leg was a major pain at first for me. But after a few weeks I adjusted to it. I did develop some amazing upper arm definition after months of crutching. Sadly, it quickly disappeared once I was cast-free.

I was probably most surprised by how quickly my leg muscles atrophied. I couldn't even stand on my leg after the cast came off because my ankle wouldn't pronate far enough to allow it. I also gained weight from boredom-induced snacking.

I hope all this helps, fabesfaves. Just remember: This too shall pass.
posted by Sully6 at 2:37 PM on July 5, 2005

I just realized my calculations on the time spent in casts was off. I broke my ankle in early June and by Labor Day I was able to walk around at a friend's wedding with only the plastic splint on. So I probably spent about 10 weeks total in casts and on crutches.

Anyhow, as for puking, I threw up immediately after surgery, right after they pulled out the breathing tube. I remember hearing my doctor ask, "Why does that always happen?" before I fazed out. By the time I was fully awake, the nurses had changed my gown and cleaned me up. It was no big deal.
posted by Sully6 at 2:49 PM on July 5, 2005

I remember my dad having this surgery, and he can be squeamish as well. I advise if you're at all uncomfortable about it to get the general anesthesia. There are side effects with epidurals as well (headache, commonly). It's way easier on you to just be sleeping during the whole affair.
posted by RikiTikiTavi at 3:06 PM on July 5, 2005

I've had an epidural. From what I remember (it was 14 1/2 years ago), the actual injection didn't hurt much at all. And it was kind of neat to poke myself in the leg and not feel it.

That was for a c-section; no general, and I stayed mostly awake for the whole thing. I was really tired, though, so once the surgery was done I went right to sleep.
posted by bedhead at 3:13 PM on July 5, 2005

I had the same thing done on my ankle about seven years ago with the general anesthesia. I have also had an epidural, and I have to say that if i had my choice between the two I would choose the general without question.

Everyone's body is different, so please don't let this freak you out, but the epidural is sometimes difficult to get in between your vertebrae, and you have to remain perfectly still during insertion, etc. Not fun. I also found it extremely unsettling once it was in to have the "paralyzed" sensation in my lower body. Of course, this was during labor, so I'm not sure how much that had to do with the general freaked feeling.

But general anesthesia! Oh, I can't say enough good things about it :) Count backwards, close your eyes, and in about one second they're waking you up and it's all done. I know the idea is a little unsettling, and there may be nausea depending on how your body reacts to it, but I found that much easier to deal with (I mean, nausea is at least a familiar sensation that you know will pass).

Ultimately, I suppose you have to trust your docs to feel comfortable with "going under"...but they'll label the leg and explain to you all the precautions they take ahead of time.

Regardless of what you decide, you will be fine! I have a laughably low pain threshold, am a true wimp, and I managed to get through both experiences just fine. Great suggestions above for recovery, too. Good luck!
posted by eileen at 3:53 PM on July 5, 2005

I too had surgery, but it was ACL surgery for my tear from a good old fashion game of non contact flag football. The surgeon was excellent in explaining the procedure and I went through GA as well.

I also threw up after my surgery b/c they gave me a Sprite to drink right when I woke up. Apparently, I drank the can too quickly and went to the bathroom to throw up. My surgeon was extremely aggressive in physical therapy and had me walking to the bathroom right after the surgery. The G.A. and pain meds helped quite a bit, but a year later I'm fine and fairly active. I bike, swim, and run at the gym; also play tennis quite a bit. Don't worry about the surgery.

Look at it this way, you can either be inactive or active. Easy choice for myself. Good luck!
posted by huy_le at 4:26 PM on July 5, 2005

GA isn't that bad: I've had a bunch of knee surgeries and never been sick or had any adverse effects beyond a sore throat and a tendency to babble a bit on waking up. mybrokenleg.com has great advice and encouragement, you should check it out.
posted by fshgrl at 5:43 PM on July 5, 2005

I shattered my ankle in a car accident and ended up with a number of screws and pins. I had GA for the surgery, and it was perfectly pleasant. I've had GA a number of times, and only once did it give me any trouble (and the only bad thing that happened then was an unpleasant feeling as I got sucked under). An epidural sounds much worse. If you're really scared, maybe they'd give you some nitrous before either the GA or the epidural...it will relax you right quick, and you'll enjoy whatever they do to you next.

I'm wimpy about pain--to the extent that I tried to talk the doctor out of surgery before getting wheeled into the operating room (even though I would have been left in a huge amount of pain and unable to walk again without surgery). And sure, it hurt really badly for a month afterwards. But the strong drugs help a lot, and you'll make it with a modicum of screaming. As of a year later, I had almost no negative effects from the original accident or operation.

Sully6 had some great suggestions. To add a few....my uncle sent me a makeup lady to give me a makeover, pedicure, manicure, etc. in bed. It was kinda silly but extremely sweet and a nice distraction. I also learned to drive an automatic car with my left foot because it was stronger. Good books, good movies, and good friends all helped.

Lastly, I learned to insist that something hurt, even if my doctor said it shouldn't. I had a rare reaction to the metal (called a bursitis), and the doctor eventually had to take the screws and pins out...but it took a lot of coaxing before he believed anything was wrong. Beforehand: "You silly women are always complaining." Afterwards: "How the hell were you walking around on that thing?"
posted by equipoise at 6:05 PM on July 5, 2005

I don't know if epidural is what the docs offered me or not. I broke my femur several years back: spiral fracture, no way to set it except surgery (I liked that conversation: the doc tells me: "sign this consent form. You don't have to, but then again you don't ever have to walk again, either..."). Anyway...

It is my understanding that the general anaesthesia is a very large part of what makes you feel like shit after surgery, and is one of the biggest risks of a (very rare) catastrophic problem. They push the stuff that doesn't knock you all the way out for a reason. I was very scared about the idea, but consented. But, they screwed something up (I heard a doc and a nurse arguing about it), and they had to put me all the way under. But I was dosed with narcotics at the time I don't even know what they were doing, or how.

Expect pain when you are done. I don't want to be a bummer, but they are going to be taking power tools to your body. My leg hurt like hell for 4 weeks straight afterwards (still hurts sometimes, 7 years later) -- hopefully yours won't be that bad. On the up side, I learned to tell time by my narcotic dosage: if I was getting grumpy and annoyed, it had been 4 hours since the last pill. And I can now feel weather systems with my leg-acheo-barometer.

It is scary. But be aware that one of the first things they tend to do after giving you an IV before surgery is to pump you full of narcotics to help you relax. They know what they are doing.

Last thing: DO NOT skimp on the rehab. The rehab., by far, is the most important thing in getting better that you control. Do every exercise they give you, and do them religiously.
posted by teece at 2:06 AM on July 6, 2005

You simply must visit My Broken Leg. It is a community support site for people with all kinds of broken legs, from the simple no-cast fib fracture right down to the shattered, never walk again types. I was somewhere in the middle; I broke my fibula and tibia clean in half about six months ago. They offered the epidural but I desperately requested GA, because I knew they were going to have to do some crazy setting down there (my foot was off at a very unnatural angle) and I did not want to be awake for the yanking and the grinding.

GA is weird - it's like that "lost time" you hear about with alien abductions. Usually when you are sleeping, you are still aware of time passing when you wake up. With GA, you're out and then you're awake the next moment, and they're telling you it's done. I have four hours missing from my life, but I know they took place because I went into them with a busted leg and came out with a plate and six screws. I did have to sign consent forms but was not really worried about GA. I was in so much pain that I just wanted to get it done. After surgery the pain was worlds better.

I'd like to reiterate: DO YOUR PT! Once you finally get to the weight bearing stage, you should get sent to physical therapy (if your orthopaedist doesn't suggest it, request it). They will give you homework - make sure you do it fanatically. Your ligaments and muscles will have atrophied in the time that you're off your feet, but it is remarkable how fast (relatively speaking) you can bring them back with your stretches and exercises. I'm not going to lie to you - it's going to hurt like hell. They told me at PT that ankle breaks are one of the harder things to recover from because of the range of motion and weight bearing that the joint has to endure. I'm six months post-op and still am only at about 85-90%. Typical full recovery is 8-12 months.

But as hard as PT was, I think the hardest part of the whole thing was being on crutches. With both your hands occupied, you are almost totally reliant on someone else to do everything for you. I was blessed with a coworker who drove me to and from work (and to and from PT!) everyday for almost 8 weeks. You can't drive, you can't carry anything (get a backpack!), you can't shower, you can't be independent. That killed me. Not to be all dramatic, but you'll find out who your true friends are through this ordeal.

Best of luck to you, and please visit mybrokenleg.com.
posted by mike9322 at 4:20 AM on July 6, 2005