Saturday 15 December 2012

What price adventures?

You may have read my blog about our trip to London on Wednesday to lobby our MP about the Beer Escalator.  I had a great day out and was happy to write about it the next day.

... but we are now three days later and I'm still paying for that day out.  I didn't get up at all on Thursday, the blog was typed from my bed.  Yesterday we managed a trip to the supermarket, but if I hadn't had a trolley to lean on I seriously wouldn't have made it from fresh fruit to margarine in Asda.  Currently I'm sitting on our sofa with two blankets and a hot water bottle waiting to be taken out to see the new Hobbit film at our local cinema.  The OH took me into town this morning to buy the tickets and some more Christmas cards and I'm not kidding but I had to go up and down the stairs at the car park one step at a time because my right knee and my left ankle just don't want to know!

On Wednesday, on the way back from the Houses of Parliament I discovered that leaning on the OH's arm wasn't working as my left shoulder had for some reason decided to seize up; swapping my bag to the left and holding the OH with the right didn't work either as the pain of a bag strap on that shoulder was shocking.  As soon as I could get sat down and one of our sandwiches to eat I was popping the co-codamol and carried on doing so at regular intervals for the rest of the day.  My feet swelled up so much on the coach on the way home that the OH had to undo my laces and wiggle my boots on my feet for me until the feeling came back.  Walking from coach to toilet at Peterborough services was like a marathon ... I was so, so pleased to see our house that night.  Unfortunately as I went to bed - with a nice hot water bottle - I started getting cramps.  Both feet, especially my toes, wouldn't stop screwing themselves up into horrible knots.  Sleep fortunately came quickly and deeply (except for the usual cat related disturbances in the early hours).

The tiredness and the aches and pains are what the doctors diagnosed as Fibromyalgia 6 or 7 years ago.  A few day's rest after a day out and lots of co-codamol and I usually pick up again.  But unfortunately these just add to various other underlying problems I've had for years.

I think the thing that worried the OH the most on Thursday (he's used to me not getting up the day after an adventure) was when I dislocated my left ankle trying to pick up a pencil (or was it a book mark - I forget), the twisting out of the bed whilst my ankle was held in place by the bedding caused my ankle to pop out of joint very painfully and I'm sorry, but I did shriek rather.  This happened again last night in similar circumstances, except I was getting into bed and the OH was already asleep so I just huffed and grrrrr'd and wriggled my foot until it popped back in.

You have to imagine the ankle joint as a kind of mortise and tenon joint, the bone at the top of the foot, the talus, fits into a notch made on the top and inner side by the large long bone, the tibia, and on the outside by the thin long bone the fibula.  When it dislocates the talus tips (twists) over sideways and tries to escape out of the joint - a lot of pressure is put on the distal (bottom end) of the fibula by the pull of the tendons as they over extend.  When people break their ankle it is usually the distal end of the fibula that has been pulled off. 

Radiograph (X-ray) of a right ankle (from imaios.com)
When I was a child don't think I managed a term at school without spraining an ankle, and on some occasions one after the other, ending up with the interesting task of limping on both sides for a week or so until the swelling went down.  I also used to pop the cartilages on my knees on a regular basis, usually when attempting to play netball!  My mum must have got very fed up with collecting me from school, carefully conveying me to Stafford Hospital only for the X-ray to show nothing at all - for as I now know the cartilage in your joints doesn't show up on X-rays. 

About 18 years ago, while living in Sheffield, I fell on my ankle, in the usual way but the swelling didn't go down in the usual couple of weeks so I called in at my GP's in the hopes of something to help.  The doctor was bemused by the feel of my left ankle - things that shouldn't move did and things stuck out that shouldn't.  He referred me to the hospital for some tests.  I studied radiography 1990-1993 and qualified as a radiographer, but hadn't worked as one due to the break up of my first marriage and the need to care for my two children who were very small at the time.  So when the specialist said he wanted to do a stress view of my ankle I wasn't very happy as I knew exactly what that was going to entail.  He got all suited up in lead lined apron and gloves and got ready to pull on my ankle just as the radiographer (a girl I knew well!) took the picture.  Arrghhh! 

The outcome was that due to the very large range of movement in my joint I needed an operation to stabilise it or I would continue to fall over at the slightest provocation.  It was all arranged and I remember asking not to have a general anaesthetic so that I could follow what was going on whilst they opened up my ankle.  They gave me a spinal block (like the epidurals they give women for pain relief whilst giving birth) and I couldn't feel anything below the chest.  The operation was very surreal - the specialist bobbed backwards and forwards from his surgeon at my foot end to my head end to tell me what was going on.  When they opened up my ankle he described the lower end of my fibula (that's the thinner bone that makes up the joint) as looking like a Vienetta ice cream - layers of bone chips and cartilage that had formed each time I had broken the ankle over the years.  It seems that many of those sprained ankles as a child had actually been breaks! 

Is it ice-cream or is it my ankle?
Because of the lengthened distal end of my fibula and the general flexibility of it they couldn't stabilise the joint in the way they had intended, by putting in a plate and a screw, but they did shorten some tendons to tighten it up.  The specialist warned me that the next time I fell I would probably ruin the work they had done and recommended that I didn't wear high heels and to avoid cobble stones.  That's why I wear boots - all the time.  Because about a year later I fell over a stone in a grass verge, in the dark, on the way back from the pub, whilst carrying take-away chicken.  I did ruin my ankle again - but I didn't drop the chicken! 

Whilst he had me on the operating table and under the epidural he demonstrated that my right ankle was just as bad and my wrists had unusual flexion as well.  One theory was that the steroids I had been given for asthma as a child had caused my joints to grow incorrectly - soft tissues grow faster than bones with steroids - I already knew that my short-sightedness was due to the same reason (my eyeballs grew quicker than my eye sockets, so they got squashed). 

Too much exercise leads to my tendons and muscles being unable to keep my joints as firm as usual and I seem to now have a period of extra wobblyness after a great adventure to add to the various aches, pains and just plain tiredness. 

But on the positive side -  I'm quite good at yoga ... very flexible! 

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