The Black Sheep Ankle Break

Heather’s May 29, 2016 Broken Leg and Surgery

Account of the break:

Well, that was an exciting and unexpected twist of events. Went out this morning with my coffee to support and guide Zak as he worked Jac on the sheep (we raise Black Welsh Mountain Sheep), saw a bucket in a potentially hazardous spot, thought "someone's going to break a leg with that" so went in to move it. Torleif slipped in behind me just as a few sheep broke their gather and Jac sprinted around to bring them back to flock. The sheep were bolting towards us pretty fast, I planted one foot and turned to make sure Torleif was safe, the sheep parted ways like water past the rock he was standing on, but one of the ewes slammed into my leg, full bore, broad side. I flew up into the air, watching my coffee leave my mug and float in space as I fell back towards Earth, landing flat out, about as gently as I could for Baby.
I lay there, a cold sweat breaking out and nausea over-taking me. Rolling over, shooting pain radiated up my leg from my ankle. Looking at my ankle, it didn't look quite right, ah, a dislocation, bummer. Zak got me out of the sheep pen, and that was about as far as I could go before a fresh wash a nausea hit. Zak got me some ice and crutches, I laid there until all was set to head to the hospital. Elka stood watch literally standing over me as our tiny pigs came over to investigating, not letting them get too close, once they wandered off she gave me a couple of feet space and kept guard, not allowing any other creatures near me. Valko cried from teh pen he was still stuck in. I am so humbled, honored, and amazed. Torleif gently placed flowers on me and tried "hand-of-healing" to fix me. He cried when he was unable to do so and lay beside me until we were set to head to the hospital. I cried at his efforts, care, and compassion, I love Torleif so much. Thank You so much Jeff Smith for staying home and adventuring with Torleif while we went to the hospital. Had a case of MRSA come in while we were there and apparently there's a Measel's outbreak too, much more wonderful, and safer, for him to be with you.
Once at the hospital, taking the ice off, I wasn't so sure about my ankle not being broken. I've never broken a bone in my body before, so wasn't really sure, but it sure looked broken.
A few x-rays later, not only is it broken, my Tibia is broken across down near where it attaches to my ankle and my fibula has a nice spiral fracture also down low, the diagnosis is Bimalleolar fracture, left, closed, initial encounter, for all you more technical folks. Requires surgery to fix, will learn more on Tuesday with the Orthopedic Surgeon. I can already feel my body trying to knit the bones back together. Nothing like being 35, pregnant with my second child, and needing surgery for breaks gotten going in where I had no intention of being in order to prevent broken legs. Ah, the irony.

Feeling very positive though, I plan to use the time to teach Jac as many vocabulary words as he's up for learning and get several long postponed paper work type projects well worked out. Thinking of taking up long distance running too... hahahaha Certainly feeling thankful for a loving and supportive family along with effective medicine, hopeful the breaks heal really well once put into place. Ice is a savior in such circumstances, still haven't taken any pain killers, but they're here if I need them. Not sure the image shows the breaks very well, but there's a copy of the image they sent home with me to show Torleif why a different Doc had to also help Momma heal. <3 Feeling loved, feeling better and optimistic. Glad Baby is safe.”
Surgery Account -
Met with Dr. Smith for a consult the following Thursday, June 2 and discussed possible healing plans.  After reviewing the x-rays and much discussion, it was decided that surgery was the best option.  Surgery was scheduled for the following day, Friday June 3, at noon, check-in 10AM.  Zak took the day off from work to take me in.  Very thankful for Affordable Health Care making this entire surgery even possible, without it this would have financially derailed our little family for the foreseeable future or not even been possible at all, which would have really derailed our family forever.  Jeff took Torleif and had grand adventures with him while I underwent surgery prep, surgery, and post-op recovery, so very thankful.
Surgery prep involved wiping my entire body down with antiseptic wipes, pretty wild.  Getting all of my vitals, and checking in on Baby’s heartbeat.  Baby was a little challenging to find and made a sound like a chirping chick initially.  Finally got their beat, healthy Baby!  Then an IV went in and one last trip to the bathroom before surgery.  Incredible, the nurse said it was ok for me to move and that she’d help, still, IV in place, I did not want to move.  Something about a needle sticking out of my hand made me feel like it was a bad idea and I noticed myself limiting my already limited movement, feeling concern about moving even with the nurse’s assistance.  Brought the idea of women in hospitals, attached to IVs, sure they can move, but do they?  I hear not, yet my own experience of childbirth involved a lot of movement,  Hmm… I don’t think this is how our species got to be so prolific, this did not feel like what could ever amount to a positive birthing experience and we’d only just begun the many similarities to so many women’s birthing experiences in this day’s surgery.
Talked with the Anesthesiologist Doc next.  As a teenager I had a spinal tap, followed by a severe headache that lasted for what seems like weeks.  The Anesthesiologist recommended I have an epidural for the surgery and two nerve blacks, as the combination would keep me pain free for the surgery and the 24 hours or so beyond, while not effecting my blood stream or Baby at all.  If I wasn’t pregnant for this surgery, I’m not sure I would have been brave enough to go that route, as it was I didn’t really have a legitimate alternative, certainly feeling the surgery wasn’t an option. 
The nerve block was done while still in the pre-op gurney.  Really neat procedure, the Anesthesiologist started with a local numbing agent, then put a large needle in and guided by ultrasound found each nerve correlating to the inside and outside of my ankle where the operation would take place.  Then he injected an anesthetic (don’t recall which one) which surrounded the nerve and pretty quickly rendered my ankle without feeling.  Then we were off to the operating room, which was Freezing cold.  Temperature was to keep bacteria down and also to keep the surgeon and others working on me from dripping with sweat under the big lights.  Most folks aren’t conscious by the time they get to the operating room, so for me they continuously traded out warm blankets and still I was shivering, pretty amazing.  In the operating room they switched me onto the narrow operating table, sat me up and prepped me for the epidural.  I was warned it has a warming effect and that the epidural is gravity based as to where it takes effect.  I sat up right with my legs dangling down for the epidural.  No joke about the warming effect, it felt like a seat warmer moving down my lower back through my butt, down my upper legs, into my lower legs and finally into my feet.  After a few minutes to make sure the numbing stayed down where it was needed, I was laid down.  The test for numbness to pain was with a cold towelet, temperature and pain being perceived in the brain together.  Once I could no longer tell cold temperature sensation we were good to go on surgery.  I could not move from the waste down at all no matter how I tried and while I could feel that I was being touch, pressure, I could not feel anything else at all.  Being pregnant, pregnancy and child birth close on my mind, I commented that I could not believe women went through child birth this way.  The Surgeon and Anesthesiologist were both surprised and someone else said “oh, I thought you were pregnant with your second child and that you’d gone through birth before”.  I said, oh yes, I have, I home-birthed, didn’t use any drugs at all.  Not for the first time I was told I was very unusual.  The surgeon and Anesthesiologist both said that most people Don’t want to Feel Anything, See Anything, or Know Anything.  We then had a discussion about our fear based society and I was able to share some of my perspective about going through labor being able to feel, see, and know what was happening.  Feeling, I was able to breathe through contractions that would be harmful, able to aid in those Baby was working for too.  Being able to feel, know, and move I could assume a position that aided my body and baby in getting Baby out in a safe and timely manner.  I just could not fathom attempting child birth lying on my back with no ability to feel or move my legs.  The entire child birthing experience was unquestionably the most profound, empowering, and gratifying experience of my life.  How much the prevailing fear based societal take on birth and birthing deprives, disempowers, and steals the entirety of the birthing experience from so many women and how harmful that is was discussed.
My leg was fully wiped down a couple more times to ensure no bacteria was living.  A screen was placed between my face and ankle.  I commented that was too bad, that I’d love to be able to watch.  Everyone was surprised, said the screen was for sanitary reasons, I commented I bet it was more to make sure despite whatever I might say that I didn’t freak out, they agreed.  The Anesthesiologist offered to take pictures through the surgery and to show me, but to let him know if I changed my mind at any time.  Before surgery began there as a “Time Out”.  Everyone stopped what they were doing, looked to the surgery notes board and went through every piece of pertinent to the surgery information any of them had knowledge of and asked if everyone was in agreement.  A couple of questions came up, having to do with not using antibiotics with me (risks outweighed benefits with Baby on board) and then it was surgery time.  The Anesthesiologist snapped images away, showing me throughout the surgery, and chatted with me about what was being done.  As I was able to view each image I got to ask the Doc questions while the surgery was happening.  So cool!! 
The Doc showed me the plates going in prior to them going in.  Turns out they don’t look like door hinges at all, who knew?!  They are long, thin, malleable metal alloy pieces with a whole bunch of holes in them.  The surgeon places them next to the breaks, predrills holes into the bone, screws them in, which snugs the plate up to the bone, and then puts locking screws in to secure them in place.  Lastly an x-ray is taken to ensure the screws don’t stick out on either side, or in my case straight through into the other bone (oops) and replace any screws that are too long with shorter ones.  I had real led underneath me the entire time and a huge, heavy, real led “gown” over the top of me to ensure Baby stayed safe from the one x-ray that was taken.  Apparently my fibula was broken worse than the x-ray showed, with a large piece in the spiral fracture being disconnected completely.  Had to screw the plate to either side of it, very glad we did surgery, it likely would not have healed in place, same for the tibia being broken off where it connects to the ankle, needing to be clenched together to plate into place.
After the plates and screws were all in place the internal soft tissue was sewn together with dissolving thread and then the skin was stapled shut.  A bandage was wrapped on, then another one, and finally a rocking boot.  Everyone in attendance agreed that This is how surgery should be every time and how much of a pleasure it was to work with me as well as insightful and enlightening, they’d had no idea about the benefits of natural child birth as it was not something any of them had any experience with (not withstanding that they were all men).

I was rolled into the recovery room, stage 1.  Spent about 20 minutes there checking all vitals and sense of feeling before being rolled back to where I’d started, recovery 2.  Zak joined me there a short while later after his debrief with the Doc, what a sight for my eyes, so in-love with this man and so incredibly happy to behold his image every single time.  There I was told the criteria for leaving was being able to pee.  Ok, I thought, let’s just get some feeling in these legs shall we, or at least the right leg, and then off we go.  Wow, took what seemed forever to gain what seemed enough feeling in my right leg to support me with my crutches, the left would be numb yet for another several hours with the nerve block.  I called the nurse over to try and stand.  Swung my legs over the side of the bed, went to stand up and almost immediately went to fall on the floor (so thankful Zak was right there to catch me – swoon).  I could not feel my pelvis area at all, no sensation what-so-ever, having been sitting upright with my legs up too, the remaining epidural had pooled in my pelvis, making it impossible to direct either leg at all.  Did not anticipate that.  Back to considering how on Earth do women go through child birth this way?!  It seems insane to me to even consider that as an option.  I recalled my Mom telling me about just after birthing Erica (my twin) and I, she noticed her leg about to fall off the table and had a hard time getting anyone’s attention from her two baby girls and to her to get help getting her leg back on the table because she could not move her leg at all by herself.  Discussed child birthing beliefs, our fear based society, and how detrimental it is to women and their babes alike.  Then what I really came to is that it’s not “just” birthing that is so entrenched with fear, but every facet of our lives.  Our entire society is based in fear, the further each of us is taken from the wholeness that comes from being loved deeply and truly, being nurtured by ones parents and community, the further we believe we are separate from the natural environment to which we are all a part, the further we will be from what truly makes us feel peace, joy, and wholeness, and the easier it is for industry, corporations, and both people and planet destroying practices we will accept in our attempts to feel those lost pieces.  The true tragedy is not “just” in each mother’s lost experience of empowerment, gratification, and triumph over the life/death line she knowingly rides in order to bring her child into this realm, it is the life long struggle to find place, belonging, nurturing, and well-being.  As we are told breast milk is not ideal, to leave our newborns in cribs down the hall, with no possible way of nurturing them and offering them their needs as they arise.  We are told each mother needs to return to work, that this making money trumps making safe Babies, who feel safe, which leads to healthy humans in the future.  The pandemic of deficit based thinking and fear has taken over every facet of our lives.  A woman in her power, knowing her strengths and that she is capable of Feeling, Seeing, and Knowing is seen as unusual, rare, and something to strive for by those in attendance was eye opening and inspiring.  How to help shift society away from all this fear and into each accepting and taking their power, their interest and capacity to feel, see, and know, that is a question I have been struggling with since.
I was finally able to stand well enough to go pee, still a monumental task and still didn’t regain feeling in my pelvis until sometime after.  On the way to the toilet I felt a cool tiny stream down my lower leg, oh no, I started peeing already!  I finally made it to the toilet, sat down, and nothing.  I sat there for a relatively long time, pretty sure I couldn’t actually pee.  Had to take several deep breaths and forcibly tell my body to completely relax, ah, couldn’t feel a thing but heard liquid falling into the toilet.  Can I stop peeing I wondered, trying to do so at the same time – No.  So I sat there and just peed and peed and peed until there was nothing left and my body had to stop.  Got up and headed back to the recovery room, laughing with Zak about pre-potty peeing and then having such a hard time actually peeing, but that “I’d been able to Pee, we could leave!”  It was just after 6PM, surgery had begun at noon, I’d been wheeled into the recovery 1 room at two minutes past 2PM.  Successfully having peed I was disconnected from all the machines and Zak was able to help me get dressed and away we went. 
Sometime after that I was finally able to feel my pelvis, “I have a vagina!” I announced to Zak who laughed and said he was glad to hear it.  At that time I was able to feel how compressed my pelvis had become in that position for so long, another piece to the puzzle, on our backs, numb, and unable to move is no way to bring our Babies into this World, harmful to Momma and also the Baby. 
The nerve block wore off some time in the first night leaving me with intense pain in my ankle, despite still not having full feeling in my entire leg and foot.  The Surgeon said post-surgery would be a lot more painful than post-break, he wasn’t kidding and disappointingly correct.  I took the Oxycodone that was prescribed, four the first day, three the second, two the third, and none the fourth.  I was warned that stress to Baby with me being in that much pain would have longer lasting harmful effects than taking what I needed of the prescribed opiates.  The plates on the bones give me the structural support to stand for the bones and the walking boot gives me the structural support needed for the cut soft tissue to stand.  While the pain continues to subside and I continue to stretch and add weight, I use the crutches for support.  It is now day five and I still do not have full feeling in my lower leg and the arch of my foot.  I am able to take more weight and for longer durations each day though which is uplifting.  The projected healing time is eight weeks.  Cleaning and re-bandaging my ankle the third night it was incredible to see the amount of bruising, how the staples looked, and the swelling beneath the bandaging.  Looking forward to the next bandage change and seeing how things are progressing at least externally.  Zak applied a cottonwood salve to aid in healing after washing, pouring hydrogen peroxide over it, and then rinsing again, the wound.
Perhaps one of the greatest gifts in all of this is the time I am now getting to stay home with my child, Torleif, to play with him, build things, draw, read, cuddle, no time pressures at all.  The stress free time shared with him is invaluable to me.  I am so very thankful to all of the family and friends who have dropped everything else to come help in this time of great need, who have been supportive, encouraging, empathetic, offered gentle advice for healing, offered help to Zak as he has had to take on every farm, house, and care of me task alongside working full time.  It takes a village and I am thankful to be part of such a loving and generous one. 
Interesting post-op learning, healing bones takes an additional 10-20% calories, this on tip of the additional 300-350 calories I needed for growing baby, and not even sure how many additional calories to continue nursing Torleif.  No wonder I nap so often and am so hungry, my body really is working very hard while lying or sitting here.  Good to keep in mind.  And now, back to the work of growing Bodies.  Keeping others in my heart and mind as we each go about our own struggles and gratitude’s for the blessings we are bestowed.