Fractured Heels Recovery
by kenneth panco
Last Update - April 5, 2021
Fractured Heels Fighters - I created a closed facebook community to allow those suffering from fractured heels to communicate with each other where rule #1 is POSITIVITY ONLY. If you are interested in joining click here. I have also created an Instagram account that include Physical Therapy Exercises and other to be determined content.
I decided to write this because when I was injured, I couldn’t find much information online about what the recovery and rehabilitation process was like for someone with bilateral calcaneal fractures (fractured heels). My hope is that any of my recovery story can be used to benefit someone else with the same injury or any other injury where the odds are stacked up against you.
My intent is also not sugar coat anything or paint a different picture than what I actually experienced. Every recovery is different, but at the end of reading this I don’t want you to think I I had it any easier or harder than you. Recovering from fractured heels is challenging, both physically and even more so mentally, but as long as you are prepared for it and truly want to get back to a normal life I can attest to it absolutely being achievable.
If you would like to learn more about my recovery or have specific questions for me I'd be more than happy to speak with you directly and help as much as I can. There is a contact me section at the bottom of the webpage or simply use navigation at the top of webpage to be directed to that portion of my story or by clicking HERE.
July 7, 2014 - The day my life was flipped upside down
When I slipped, my left foot was already hanging over the roof and my right foot went through the gutter. During my fall, the only thing that came to my mind was to not do a ‘pencil’ like I used to do when jumping into deep pools growing up. My rationale was that if I could cushion the impact maybe injuries would not be so bad. I will never know what my injury outcome would be be if I landed any differently, but safe to say I’m glad I was able to react as quickly as I did. The only way I can describe the impact was like having an elephant sit on your chest.
When I regained conscious, from my fall, my original thought was I didn’t injure myself as badly as I soon learned and I did not realize how much of a life changing injury I had sustained. I elevated both of my legs, my mother was a nurse and grew up with many sports injuries and knew elevation was the first thing to do, and I could wiggle my toes and bend my ankles. After a couple minutes I decided to try and crawl back into my house and quickly realized something was seriously wrong.
Paramedics got to me within about 20 minutes and was quickly transported to St. Mary’s Hospital in Langhorne, PA. While still on the ground I wanted to know what my injuries were and what my feet looked like. I couldn’t see any blood anywhere and my ankles were still in their proper place nor any bones exposed though my skin so it was not evident to me what I actually did to myself. Extremely alert, I was wanting to know what my injuries were and what my feet looked like. When I asked the paramedics their only comment to me was:
“Well the good news is we can’t see any bones.”
Believe it or not I only had one cut on the inside of my left forearm that didn’t even require anything to stop bleeding - was more like an abrasion.
When in the ambulance I remember the pain starting to hit me and the paramedics unable to get it under control. To their defense, they were trying, but I found very quickly morphine doesn’t really help me with pain (at least for this severe of an injury). The only way to describe the pain / sensations I was experiencing was that my toes felt like they were sitting in a campfire and my ankles felt like they had a boa constrictor wrapped around them (tight squeezing sensation).
Once in the trauma area I was x-rayed all over my body and injuries I sustained were slowly relayed to me. Conversations started unfortunately with a medical staff member telling me how severe my injuries were and how daunting the recovery is. I really had no idea what he meant as he didn’t tell me the injury so responded to him:
“What do you mean? Do my feet need to be chopped off?”
because he repeatedly told me how bad my injury was. That medical staff’s boss must have heard my question and quickly jumped in and said:
“Stop scaring the guy, you have at least one broken heel and yes it is a very tough recovery and we will know about the other ankle shortly.”
Shortly thereafter a fracture of my 2nd heel was confirmed but they also said I broke my back in two places. This came as a shock as the pain was so bad in my feet that my back didn’t even hurt.
Eventually I was taken to a temporary room where I awaited all the insurance procedures to take place. I remember family and friends starting to trickle in and seeing them in shock. I tried to disguise the pain and anguish I was in. I hid it so well that I was repeatedly told by medical staff how they couldn’t believe how alert and positive I was for the injuries I had sustained, but when my sister came in and said, “It’s okay to cry”, I broke down. I already knew I was in for a hard road to recovery and couldn’t hold it in anymore. I had already decided to myself that I was going to work as hard as I could to beat all the odds stacked against me, but the challenge in front of me at the time seemed insurmountable.
While I was still in the temporary room, the only other thing of substance I remember was medical staff coming in, looking at my X-Rays, and cringing.
I was at St. Mary’s for 3 days 2 nights and the first 2.5 days were in just as much pain as I was when injury occurred. My toes felt like they were in a camp fire and ankles crushed. Sleep was non-existent and the frustration with medical staff not switching my pain medication caused me to freak out until they put me on dilaudid. Finally after 48 hours of immense pain and no sleep I was able doze off. Once the pain was under control and I was able to demonstrate I could get in and out of a wheelchair from the bed I was allowed to be discharged. I went home understanding my feet were too swollen to operate on and would need to meet with the orthopedic surgeon a couple days later to determine what operations were needed.
With my living room being turned into a hospital room, I quickly settled into what would be 3 months of being restricted to a bed. The most important instruction to me upon being discharged from the hospital was to keep my feet elevated and don’t move my ankles and that’s exactly what I did.
When I look back on my recovery, I think an accurate way of describing it is that I had tunnel vision. Nothing else mattered. Completely and utterly consumed. I only thought about my recovery and what I needed to do to be the person I was before I fell. To say I was completely consumed with it was an understatement. It was literally the only thing I thought about. I just needed someone to take a chance and give me the ability to work as hard as I wanted to so I could recover physically.
Being told to not move my feet for 3 weeks? Easy.
When I went home, I had an immense amount of support from family and friends willing to help. My closest friends stayed the weekend and one even flew all the way in from San Francisco to be there for me and help wherever needed. It was a nice distraction and went a long way in the first couple of days home.
The biggest problem I ran into once home was getting pain under control. I wouldn’t have been allowed to go home had I still been in pain, but the dilaudid might have still been in my system. When I went to bed the first night, I quickly found out that taking dilaudid orally had nowhere near the same effectiveness as an IV and the pain grew immense again. The first night I was home, I had to wake up my friends who were staying over at my house to have them wake up my wife to call my surgeon to get different pain medication. Unfortunately it took about 8 hours to get the proper medication and spent the time waiting in agony. This was actually the first time I could feel the pain from my broken vertebrae.
The 2nd issue at home happened when I woke up to blood on the outside of splint. Concerned, I immediately called the surgeon's office. They mentioned it was most likely a blood blister but to come to the surgeon’s office on Monday (noticed the blister on a Sunday morning). When I got there the issue was confirmed but it soon turned into the hardest conversation I have ever had to take part of in my life to date.
For some background, when I met the orthopedic surgeon at St. Mary’s he mentioned he already looked at my X-Rays and was very optimistic. I soon found out this was not the case and that he didn’t even know if I was operable. Dumbfounded hearing this I began questioning him to which I was told:
I may never walk again
I’d battle addiction to opiates
I’d battle depression
I’d never be painless
No one is ever happy with the outcome of calcaneus surgeries
Hearing this I sobbed uncontrollably. A feeling I would never wish on anyone. I felt like my life was over.
When I was originally discharged, I left St. Mary’s trusting that someone was honest with me and that I was going to be able to be given the opportunity to rehab and get back to a life I was accustomed to knowing. I already knew how much effort I had planned on putting into my recovery. The surgeon left the room to review the x-rays with someone else and returned about 10 minutes later or so and told me that based on my positive attitude and willingness to fight in rehabilitation that he was going to go out on a limb and be more aggressive in my surgical procedures. Being quickly at rock bottom this was incredible news to me and went home at least happy that I was going to be operated on vs. having my heels heal as is.
I’ve been fortunate enough to have some close friends work in the medical device industry. A couple days after I returned home, a colleague of my good friend, who was selling the hardware to the surgeon to be used in my surgeries called my friend and told him about the scheduled surgeries which was different from what I was told a couple days prior.
Regardless of if I would have agreed to those surgeries or not, my friend called another friend of mine who sold the same hardware to the Chief of Orthopedic Trauma at Penn Medicine and was able to get me into see the surgeon who gave me my life back - Dr. Samir Mehta. Dr. Mehta saw me on a day he does not typically see patients and spent as much time with me as I needed. I knew almost immediately Dr. Mehta was all I ever wanted in a surgeon. He was brutally honest with me but also confident that based on what he saw in images that I was operable and did not require more of a devastating surgery as what the previous surgeon told me. Rehabilitation would still be extremely tough but I didn’t care as that is something I could control. Dr. Mehta spent almost 2 hours with my family and was instructed surgery would be 2 weeks later and I would be re-splinted (which was a nightmare). Marching orders were keep feet elevated and iced, not to move my ankles and to eat 4000 calories a day which I soon found was a lot harder than I thought being the amount to pain I was in that really curbed my appetite.
That amount of calorie intake was required because I was told that because of the traumatic nature of my injury my body went into overdrive to repair itself. I do recall barely being able to eat anything for the first 10 days or so post injury and based on how I looked in my torso I, I guesstimate I lost roughly 20 pounds.
I got home and time stood still. Days felt like weeks and I just couldn’t wait to get my feet operated on. I sat in bed, kept my feet elevated, didn’t even attempt to move my ankles and waited.
Only July 28, 2014 I had my right heel operated on. I couldn’t wait to get one step closer to being able to have more control in my recovery. Never being put under to be operated on, I remember how cold the operating room felt but was quickly put to sleep. When I woke up I was extremely nauseous but was taken care of quickly and learned surgery was about 3 hours long. I recall not being in much pain as they implemented a nerve block in my entire right leg so I had no clue how big of a shock my body was in over the extensive surgery. Once the leg block dissipated I quickly found out how extensive it was. Not asking me how my body reacted to morphine I found myself in agony. One hundred times more pain than what I ever experienced prior to surgery and being medicated on a drug that has minimal effects on me. I remember saying to myself:
“How the hell am I going to get through this?”
I started reaching out to nurses to do whatever they needed to do to change my pain medication. I guess the only way to describe the pain would be just as you might think the sensation would be if your entire heel was removed from your body, pieced back together and glued with titanium plates and screws. I don’t recall how many times I needed to ask until they finally got someone from pain management to see me to approve switching to dilaudid.
During the waiting game of getting my medication switched I was able to devise a way to slightly alleviate the pain and put all the weight of my foot on the area of my foot by my big toe by using the board used to get in and out of bed from the wheelchair.
No idea how I was able to figure this out in the amount of pain I was in, but I had to do something about the pain myself since no one else really was operating at a speed I needed based on the amount of pain I was in. Once I was put on dilaudid the pain was almost immediately under control but we needed to hit the button every 10 minutes (wouldn’t do auto-drip), so sleep was hard to come by.
On July 31, 2014 my left heel was operated on. I believe about the same time and results from my right heel surgery but because my left heel had slightly more damage and increased swelling they needed to have some sort of drain connected to the incision. Thankfully I was on the appropriate pain medication so I did not have the deal with the same agony once the nerve block wore off. After 2 successful surgeries I now had 1 titanium plate and 12 screws in each heel and 2 pins in my talus of my left ankle. I quickly claimed that I had two ‘Heels of Steel’.
Now that my feet were finally opened up, I was very curious the extent of damage sustained. I was told I did not have any cartilage damage in my right ankle / heel but unfortunately there was cartilage damage in my left. Essentially, it’s safe to assume I’ll develop arthritis in my left ankle sooner than I will in my right. Based on where I am currently in my recovery (it never ends) and daily pains in each foot it’s evident my left foot sustained more damage. In medical terms, my left heel fracture was classified as a Sanders 4 (IV) and the right heel was between a Sanders III and a Sanders IV.
I was discharged on Sunday, August 3, 2014 upon pain being under control when taken orally. For the amount of pain I was in, I needed to take 40mg of Oxycontin every 8 hours and 10 mg every 4 hours totaling 180 mg of Oxycontin a day. Heading home and back to the hospital bed was a lot easier this time knowing the waiting game of getting surgery was behind me. I did as instructed and ate as many calories as I possibly could and kept my feet elevated and did not move them. Even though I could not move my ankles I did start working on maintaining my upper body. I tied bands to the hospital bed and started exercising my upper body in any way I could to help mentally. Ever since 9th grade I found myself in the gym 4 - 5 days a week and needed some semblance of normalcy. I have no idea if this was something I should have done, but in my opinion, as long as I didn’t move my ankles I didn’t see how it could hurt. As I became less restricted to the bed (was able to be in a wheelchair eventually) work outs became more intense as I would do:
Shoulder exercises and bicep curls with 10 pound plates to exhaustion
Pushups with my legs elevated with all weight being being beared on my shins
If you are reading this ask your surgeon if this is copacetic but at that point I was just doing what I needed to do for my mental health.
Being told on 7/14/14 that I would be addicted to opiates I was very cognizant of whether or not I was feeling any differences in pain when on the medication. About 3 weeks or so post surgery, I started to not have the same effects, so I decided to stop taking the pain medication. What I didn’t know was that my body was already addicted. One morning I decided I was going to try and stop taking them cold turkey but by the evening I was suffering severe side effects of withdrawal. I would cry out of nowhere, was sweating through clothing and felt like I was getting punched in the stomach which got increasingly worse as the day progressed. Eventually, it got so bad that I gave in and took one 10mg pill of Oxycontin and within minutes all my withdrawal symptoms subsided. I quickly realized I needed to slowly wean off the medication and was able to wean off all the pain meds within six (6) days. I can certainly understand how people get addicted to opiates, but all I can say is if you want to get off them, you can. No excuses. If you don’t truly want to beat the addiction you never will.
Looking back, I realize that the pain medications were aiding in my sleeping immensely. Once I stopped taking them I barely slept because of the sensation in my toes that I believe was coming from the nerves regenerating. The only way to describe it would be it felt like my toes were being electrocuted. Sharp, random and intense ‘zapping’ sensations that seemed to start at bedtime. Sleeping was also a challenge as I would wake up in pools of sweat from weaning off the pain medication and because my legs had so much atrophy that when I would try and lay on my side it was like bone resting on bone which was incredibly uncomfortable.
Tuesday, August 19, 2014 I returned to see Dr. Mehta for x-rays and have stitches removed (show pics). I was insanely curious what my ‘new’ feet looked like as this would be the first time I saw them since being repaired. Other than some swelling, they didn’t look bad to me, but when I was finally able to see the stitches and length of incision I was taken aback. I honestly had no idea what to expect and quite frankly I didn’t care how they looked, I just wanted to get back to walking. Dr. Mehta was very pleased with the healing process (both incision and fractures) and was fitted with walking boots (to not walk in) for use when being transported. The best news of all was, while I was still not able to bear weight as the fractures were not fully healed, I was able to start working on my range of motion. As soon as I got home I started to execute my plan of giving everything I had into recovering.
The 2nd best outcome was that I was finally able to shower. Having the shower equipped with a waterproof chair, I remember crawling upstairs immediately upon getting home to take a shower. Getting onto the chair without bearing weight was a bit of a challenge but I was determined to, and according to my first physical therapist I could put on a clinic on how to get around without using your feet. The excitement of finally being able to shower after 6+ weeks quickly turned upside down when I touched my feet against the shower wall. I honestly had no idea what to expect, but I had zero feeling on the bottom of my feet. I was mentally prepared for an uphill battle of recovery but had no clue how steep that hill was. In many ways, when I finally touched my feet against the shower wall a realization set in that I may never be able to control how my feel feel vs. getting my range of motion back and living an active life. I remember sitting in the shower in silence after I felt nothing trying to figure out how the hell I was going to overcome this. Dr. Mehta gave me all I wanted and it was now up to me to execute on my plan. Luckily for me a treatment called Graston Technique exists which I’ll explain later.
9/9/14 - Had at home bed removed from house.
My next appointment was on Tuesday, September 19, 2014. Dr. Mehta was so pleased with the healing of fractures he almost approved me to be able to weight bear but thought it would be best to wait three more weeks and was approved for weight bearing in a pool. Finding a physical therapy practice with a pool turned out to be harder than we thought but did find one fairly close by. Dr. Mehta explained to me that because I hadn’t used my feet or heels for as long as I had, your brain forgets you have heels. Thankfully, he prepped me for this but I did not care what it was going to feel like, just needed to keep moving forward.
Wednesday, September 17, 2014 - Being both anxious and nervous, I beared weight for the first time in a heated therapy pool. It felt as if you were to try and walk on 2 feet that were asleep; extreme pins and needles sensations. As exciting as it was to take these first steps, I unfortunately did not have a good feeling about the physical therapist. I had minimal range of motion and dorsiflexion. My gut reaction was the physical therapist did not have enough strength to manually manipulate my ankles. I remember going 2 or 3 more times and then just started going to the pool at the local gym I and doing those same exact exercises by myself until I was able to bear weight outside of a pool and see the physical therapist with whom I had previous experience. I was fortunate enough to have my chiropractor and friend live in the same neighborhood and would pick me up when he would go to the gym. Because I was able to do the pool exercises at my local gym I then switched non weight bearing physical therapy at Performance Spine and Sports Medicine in Newtown, PA, a short 5 minute drive from my house. Having used them for some back problems previously and knowing their unique approach to dealing with injuries, I felt at home. They wanted me to recover just as much as I did, which I believe is paramount in choosing where you decide to rehab.
Tuesday, October 7, 2014
I had my next follow up with Dr. Mehta with anticipation of getting approval to walk again. To say time stood still from the last visit was an understatement. One of my favorite qualities of Dr. Mehta is that he gives you all the time you need during an office visit and makes sure all of your concerns and questions are addressed. The first time I met with him, he spent almost 2 hours with us. This visit I waited over 3 hours in the exam room to see him because I’m sure he was doing just the same with his other patients but after looking at the x-rays I was given the green light to bear weight. Wasting no time, I immediately put my socks and sneakers on and stood up. Just like in the pool, my heels felt like I just stood on a limb that was asleep but with immense pins and needles sensations. Having not used my legs other than in the pool in 3 months, my body forgot how to walk, so first steps were not pretty as I was doing whatever I could to minimize the amount of weight being beared by my heels. Essentially my first steps were toe to heel vs. heel to toe. I quickly found out that walking this way does nothing good. Regardless, I walked the entire way back to our car in a lot of pain but loved every second of it.
To give you a snippet into who Dr. Mehta is and why I’d highly recommend him to anyone, here is something he shared with me when I told him I was going to share my story and if he wanted to describe why he decided to operate on me when other surgeons may have deemed I was inoperable and this thought process when in the operating room.
“When I met you, i realized I had a person with a Type A personality who had no idea how much his life had just dramatically changed. Calcaneus fractures have a disproportionate impact on quality of life measures. And you had two of them. I also recognized the tremendous support system that you had.
Deep breath - where do we go from here? Even in the best of hands calcaneus fractures do "just okay" and this guy has two of them. All right, well maybe it won't be as bad as I think ... maybe they are non operative or maybe not too badly broken.
Then I looked at the CT - sanders III / IV on the right heel and Sanders IV on the left heel - not good.
Okay time to role up sleeves and let's do this.
In the OR, it was as bad as I expected. After having done this for a few years you realize that the CT underestimates the amount of injury present. So, when I got in there, no real surprise. Had a plan in terms of how I was going to fix it - like putting a puzzle together and starting with the corner pieces and working you're way in. There were A LOT of pieces. During the surgery, all I could think about was "gotta get this perfect" to give this guy a fighting chance.”
Even today reading this brings me to tears. All I wanted was someone to do exactly what his quotes portray and it’s exactly what I got from Dr. Mehta.
Feedback after surgeries from a friend who was actually in the operating room was that I already knew how committed Dr. Mehta was to giving me a fighting chance at getting back to a normal life even if the damage was worse than images portrayed. I don’t even know what the devastation would have felt like if I were opened up just to be deemed nothing surgically could be done to fix my heels. I’d be lying to you if I said my desire to recover as well as I have wasn’t partially fueled as a thank you for giving it everything Dr. Mehta had and taking it as much time as needed to quote Dr. Mehta - “To give this guy a fighting chance”.
Looking back I also find myself incredibly fortunate based on my life leading up to my injury / surgery. I vividly recall when meeting the Neurosurgeon for the first time his first response to me after looking at images of spinal fractures was:
“I can’t believe you are alive let alone no paralysis”.
I actually had to ask him to go over the images with me but luckily was determined no surgery was required. The surgeon informed me that if just a sliver of bone had went into my spinal chord paralysis would have resulted. I soon found I did loose some movement in my big toe of right foot (can’t curl the toe) but no idea if that was a result of spinal fractures, something getting crushed from the injury, nerve damage or something severed during surgery. Luckily this doesn’t affect me getting around.
I’m also very fortunate to have never smoked cigarettes in my life - not even one drag of a cigarette. My parents both smoked for about the first 10 years of my life and I grew a distaste for it. During my initial consultation with Dr. Mehta one of his first questions to me was if I smoked as it has a detrimental impact on the healing of the incision and more susceptible to infection. He even went so far as to say I’d be in-operable if I were a smoker. It’s things like this that happen in your life that really makes the saying “everything happens for a reason” hit home and is a surreal feeling.
I also work very hard to eat healthy. If I ate as much as I wanted I’d be obese. I avoid sugar and any non-healthy carbohydrates wherever possible and have never really been overweight. At the time of my injury I was probably in the best shape of my life prior to leaving for Pennsylvania State University in 2001. I put on some weight during college and hurt my lower back working physical labor type jobs in the summer so I didn’t have to work throughout the school year and afford to drive and do what I enjoyed. I was raised to work hard for what you want and not expect anything from anyone. My back injury ultimately led me to the chiropractors office from not using proper posture when bending over or lifting things. Being fed up with the back pain and costs of visits on one of my last visits I asked the chiropractor what can I do to never see him again. He mentioned to use proper posture, increase your core strength and maintain a healthy weight. Hearing this I immediately became more strict to my diet, inserted 10 minutes of abdominal work at the end of each workout (which I still do) and did my best to sit with proper posture and lift / bend over with proper form. It wasn’t quick, but over the next year I lost about 20 pounds and developed abdominal muscles. I only mention this because I sometimes wonder would my injuries / outcome been different if I was 20 pounds heavier at the time of my injury? Would I be alive? Would I be paralyzed? Would I have had fractures in other areas of my body? Will never know but luckily life up to my injury seems to have some sort of impact on the severity of my injury and even impact being actually able to be operated on.
Back to walking I quickly found out I was doing too much. I remember only being able to tolerate 4 steps at a time without extreme pain. With the ‘no pain no gain’ mindset I powered through as much pain as I could tolerate but I had no other choice. After walking toe-to-heel vs. heel-to-toe I developed Achilles tendinitis in my right foot where pain was so bad it forced be back to being immobile for 3 or 4 days. Having waited 3 months to walk again this was hard to endure but it forced me to walk on my feet properly so as much as it sucked it seemed to help.
My next follow up visit with Dr. Mehta was about6-8 weeks after I walked again. The goal I set for myself was to walk into Penn Medicine without a limp with the appearance I never shattered my heels. To this day I still walk flat footed every morning as my ankles significantly stiffen overnight but loosen up after being on my feet for about a minute or so. Back then they took a lot longer to loosen up on top of the fact that I was still working to get full range of motion back in my ankles (which I still don’t have) but I made sure I was up and walking around before I was called back to see Dr. Mehta so I could at least appear I no longer walked with a limp.
Results of that checkup was that X-Rays looked good and was cleared to run!!! Prior to my injury I ran 15 - 18 miles a week so getting back to doing what I normally did was always a goal of mine especially from a mental perspective. My next follow up was three (3) months later and I set a goal of running 3 miles again (only distance I ever ran) by the next follow up. During my next physical therapy session my PT agreed to let me attempt to run but was deemed my achilles tendon was still to tight from being immobile for so long so even though I was cleared to run from a fracture perspective my ligaments were still to tight so I had to focus my attention on range of motion, strengthening my lower extremities and loosening up ligaments in my ankles that were still way to tight for running.
By April, 2015 I was cleared to start running again by my Physical Therapist. This was monumental to me because I was told when initially injured that I may never walk again let alone run and was proud of what I have accomplished in my recovery so far but was far from satisfied based on goals I had set for myself. At this point I was seeing Dr. Mehta every three (3) months to see how I was progressing and was determined to run three (3) miles before my next visit late July / Early August.
Running was not easy. I remember starting my running around the block to start and the discomfort I felt and had to listen to my body. You don’t break plateaus in any recovery without enduring pain and need to be cognizant of when you are taking it a step too far. There was pain and discomfort after running but once I tried to walk again after resting the pain was so bad that it was almost impossible to walk for any distance. This was hard to endure but didn’t come as a shock. Dr. Mehta informed me from the start that it’s going to take a while for your ankles to adjust to all the weight being bared on them again and being dormant for so long and can only imagine the impact of running on them but in my opinion there was no way my ankles would get used to that pounding unless they experienced it so I continued to power through and deal with the pain.
Up to this point in time my mentality was I wouldn’t be satisfied with my recovery until I was doing everything I did prior to my injury. About 2 weeks before my next scheduled follow up with Dr. Mehta I was up to running 2.5 miles with with my goal of 3 miles in sight and attainable. On a run when my goal was to run 3 miles I noticed a sharp, excruciating pain in my 4th metatarsal of my right foot. So much pain that ironically I could only bare weight on my heel. After consulting with my physical therapist and Dr. Mehta’s staff I was diagnosed with a stress fracture. Searching for answers why this happened I was informed it could be several factors. The first explanation was that I was just going too hard too fast and running that much may not have been wise as my feet weren’t ready for it after so much time spent non-weight bearing. The second explanation was that I was not walking on my right foot properly and putting too much stress on the side of my foot. Based on the soles of my sneakers before I don’t necessarily think I ever walked on my right foot properly but can only imagine my injury made this worse but other factors could have been involved.
Getting the stress fracture in my foot was devastating. Instantly I realized that no matter how hard I wanted to work I don’t have full control over getting back to who I was before. The realization of this and the fact that dealing with constant pain and discomfort took me into a dark place. With depression comes medicine which, in my opinion, no one should be ashamed to take. Slowly I started to accept the ‘new me’ and never realized how much of a mental challenge it is to recover from a traumatic injury especially when you can’t do the things that used to come so easily. Looking back the physically recovery was easy and the mental recovery never really ends. After future discussions with all my medical staff I made the decision to give up on running for a variety of reasons.
I’m still alive.
I have medical clearance to run / walk after being initially told both were a long shot.
It’s a safe assumption at some point in my life I’ll develop arthritis in my ankles based on cartilage damage and I’d prefer to delay the inevitable. My mother believes I already do based on daily pain but it isn’t something I worry about anymore. I live one day at a time and only think positively. I used to be a negative person and one of the best outcomes of my injury is my new outlook on life in my opinion.
During this time my days of physical therapy went slowly from 4 days a week to 1 day where eventually insurance no longer would cover additional physical therapy sessions and I was luckily physically ready to get back to my ‘new’ ‘normal’ life.
Not having the time commitment that came along with physical therapy was great but I was still getting used to daily aches and pains. I have got back into my normal weight training routine and have modified how I workout to accommodate for the lack of cardio and started wearing flat foot shoes (Vans) more often to force myself to need to use more of my ankles to gain more range of motion or dorsiflexion. I also gave more attention to weight training my lower body because the atrophy that did occur from being immobile in my legs was still fairly evident. This did result in greater range of motion, so much so that I started to feel the plates in each heel that seemingly prevented me from gaining more.
Still being committed to my recovery I reached out to Dr. Mehta about having the hardware removed. I thought it would be amazing to have it done 2 years from the day I walked again (10/7/2014). Based on our conversations it was decided we would do 1 foot at a time so I was still able to get around with surgeries scheduled for 10/3/16 and 10/17/16. The month of October was a tough one, living solo on 1 foot, but I managed to get through it based on the fact I signed up for these surgeries. In hindsight I didn’t give enough thought into the amount of pain that I would be in after not using each foot for 2 weeks but it was a goal I set and glad it’s behind me. I also got to keep all the hardware which was also part of why I wanted it removed. I can’t say I have noticed a huge difference in my heels since it has been removed but I do know they needed to chip away bone to get one plate off so if you ever have aspirations of having your hardware removed consult with your surgeon about that scenario.
Say what you will but when people ask me of my recovery and my thoughts about it my best way of describing it is the person who I was before my injury died on 7/7/14 and was reborn to a very much different person. My work ethic, drive and passion without question helped in my physical recovery but the battle of depression, the level of effort and pain endured it takes to overcome plateaus, the dealing with the peaks and valleys of recovery and the mental challenge has had a profound effect on me and changed me forever. I’ve always been an independent person and hate being reliant on anyone for anything but I can’t discount the importance the support of family, friends and medical staff had in my recovery. Unfortunately some loved ones, that I still very much care about, were hurt along the way and is a burden I will always bear. I truly believe I’m a better person today. Constantly positive, worrying only about the things I can control, using brain over brawn and being humble are just few traits that I believe describe the new me and if I had a chance to go back to being who I was before 7/7/14 I whole heartedly would say absolutely not. I have no idea what it is in store for my ankles in the future but all I can do is live life and work to be a better every day both physically and mentally. Some days are absolutely harder than others regardless of what new pain in my ankles I may encounter or what mental challenge arises but I’m still alive and able to get around and that’s all I need. The recovery is constant and as soon as you become complacent you regress.
My Message to You
If you are reading this and the odds are stacked against you and if choose to follow my path of recovery here is what I would say to YOU. In no particular order than first point below.
First and foremost and most paramount. YOU HAVE TO WANT TO RECOVER. If you are 100% reliant on someone else to get you to where you hope to be you are unfortunately facing an even steeper hill that is recovery.
Set lofty goals and expect setbacks. If you don’t experience the setbacks, that is great, but pain and adversity breed strength and I assure you when you break through the setbacks, you will be rewarded for your efforts.
Do exactly what your medical staff says and then go above and beyond. If the physical therapist says do an exercise for 10 repetitions do it until it exhaustion. If the exercise isn’t challenging it’s safe to say it’s not providing any benefit.
Cry. I’m serious. It has the same effects on you as when you are so frustrated at something it causes you to scream. For me it was therapeutic.
Just because someone says something can’t be done doesn’t make it fact. There is absolutely nothing wrong with proving someone wrong.
Ask for help.
Do your due diligence on all medical staff treating you. Ask for references. Don’t assume anything. If you don’t have warm and fuzzies I’d look elsewhere. Surgical permits are “informed consents”, I.e., your surgeon needs to explain to you what is being done and the extent the permit covers, until you understand. It’s not okay to find out after surgery something different was done that wasn’t on the permit.
Opiate addiction is real. Don’t let yourself get addicted.
In the words of Jim Valvano - “Don’t give up, don’t ever give up”
Recover better than I did.