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I fell on a cruise ship Dec 12, dislocated my ankle( which…

I fell on a...

I fell on a cruise ship Dec 12, dislocated my ankle( which was relocated on the ship, fractured my tibia and fibula ( and later discovered that Ii fractured my navicular bone). I had surgery at Scripps hospital on Dec, 15 after flying and traveling from the ship to Guatemala Ciiy 12 hours.two incisions were made, one on each side of my ankle, a plate and 7 screws were drilled into my tibia and fibula. two larger screws were inserted into the right side of my ankle. i have been at PT since Feb. 27 with 7 exercises to do, I still can;t bend my foot very well on the top of my foot and my Achilles heel.my foot gets so swollen, red and shiny I have to ice it down several time during the day. Is this normal? Why is it shiny? What can I do to make it more weight-bearing and walk? one of my PT guys tried to massage my whole ankle and put pressure on the Navicular area, which resulted in more icing down. Any suggetions?

Doctor's Assistant: How long have you been dealing with this? Any other symptoms?

Off and on since my surgery...I had 2 plaster casts and 1 air boot.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

No I'm healthy, 70 years ols and hiked in Switzerland for 2 weeks in Sept.

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Customer reply replied 1 month ago
I am doing 7 PT exercises daily.Most of them are to stretch my heel and bend my foot. I have seen progress, but it is very slow. These exercises are hard for me and make me dizzy and tired. I am used to hiking, so I can't understand these reactions.My ankle gets very swollen , and redish-purple in color. I can't do many repeats of this without sitting down and resting. Is this normal? Please do not charge my card more than $29 ,I cant afford to do this again. My insurance is covering my surgery.
Answered in 2 hours by:
3/12/2018
Dr. Mark
Dr. Mark, Neurologist (MD)
Category: Neurology
Satisfied Customers: 12,332
Experience: Neurosurgeon - Brain, spine, and peripheral nerve surgery
Verified

Hello -

Do you have a picture of your ankle when it gets swollen and red/purple in color?

Did your doctor tell you about "CRPS"?

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Customer reply replied 1 month ago
I do not have a picture of my recent swollen foot or redish -purple color.
He did not tell me about CRPS.
Customer reply replied 1 month ago
I do not want to pay an addition $50.Can't you talk to me for the $34 I've paid?
Customer reply replied 1 month ago
Please help me!

CPRS:

https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Complex-Regional-Pain-Syndrome-Fact-Sheet

is a condition that can be seen after trauma to an extremity (such as in your case), and associated with pain, swelling, redness/ changes in color, and potentially the reason for why you may be having issues in your ankle.

It could also very well be that the area is experiencing swelling as a result of activity / healing from your recent trauma.

But it may be worthwhile discussing further about potential evaluation for CRPS with a pain management specialist, as treatment early is very helpful in preventing further issues down the road.

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Part of this is being aggressive with physical therapy, and mobility of the ankle. So continuing to work hard to gain movement and flexibility of your ankle is very important.

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Customer reply replied 1 month ago
That's it? You didn't answer any of my questions. I was a teacher of the gifted, so I would give you a very bad rating for this response.

Your doctor's note does mention that you may be "at risk" for CRPS, and he was concerned about permanent stiffness in the ankle "if she does not get moving".

He is not concerned about the healing in your fractures.

He is concerned about you not moving your ankle, and participating with physical therapy.

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Your surgeon feels that you can weight-bear and walk, and that you should do this as much as possible to help with your rehabilitiation.

I hope that this has been improving with PT, and really the only way to get better is to be aggressive and really work on these exercises. You had some muscle atrophy (weakening) as a result of being in the cast/surgery, and so these muscles need to get stronger, and you need to maintain the movement in your ankle, so working on the dorsiflexion (pulling your toes toward your nose) is very important.

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Customer reply replied 1 month ago
Actually, he misrepresented me in his summary. I had NO PT activities to do until one day after my visit with him. Then I had 2 PT therapists to help me. I took my boot off immediately after our post-op visit 2-5-18, and only wore it when i went outside to protect it from people in the elevator.The entire time I tried to force my foot to the rug before we meet on the 26th.

The fact that you are having some improvement is good, although it is slow. These exercises shouldn't make you dizzy and tired, although you probably have less stamina than you normally would, because of your surgery. Let your therapist know that the exercises you are doing make you fatigued, and they can hopefully suggest some exercises that you can do resting / sitting to help with your ankle.

Really - at this point, physical therapy is the most important thing you can do. There will be pains, there will be some setbacks, but you need to increase the strength and range of motion in the ankle in this initial healing period, because this is the time in needs to heal correctly.

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And I'm sorry if you don't feel the answers are satisfactory.

If you would like, we can get a refund for you.

Best of luck.

Dr. Mark
Dr. Mark, Neurologist (MD)
Category: Neurology
Satisfied Customers: 12,332
Experience: Neurosurgeon - Brain, spine, and peripheral nerve surgery
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Customer reply replied 1 month ago
You aren't telling me anything new.I religiously do my exercises until I have shooting pain and swelling. Then I ice my foot for 20 minutes. Last night the swelling didn't go down before bedtime.AlsoIi keep a chart of all my exercises and how often I do them on a daily basis.
Customer reply replied 1 month ago
I would like a refund. Your answers are very general and don't address my specific needs.I asked many time if certain characteristics were normal. You didn't answer me.
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