Friday, January 17, 2014

Building again

I have a permanent injury to my left ankle. When I was 13, I stepped between a sidewalk and a road and bent that foot inward until the foot actually touched the leg for a moment. A normal parent would have taken their child to a doctor. A normal parent would have been concerned that the ankle was broken. I didn't have normal parents. I had a shitty mother and a co-dependent father who says he trusted her to be a good mother and thus never questioned her judgment. Honestly, there are many days that I think this was merely his excuse to absolve himself of his own culpability in the horrific childhood I endured.

The end result was that I did not see a doctor for my ankle until I was over the age of 30. My mother, who thought because she was a medical student meant she knew everything about all areas of medicine, declared it was not broken. I was ordered to stop crying or be spanked severely to justify my crying. She slapped an ace bandage on my ankle and told me to walk. After four days of my inability to walk, she did finally break down and buy a pair of crutches for me to use. However, three weeks after the injury she declared there was no reason for me to need those anymore and took them away from me.

I hobbled for months, slowly rebuilding. The next year when I attempted to run track, I discovered I was quite fast in speed, but after every track practice, that ankle felt like it was on fire. I suspected there was something permanently wrong, as she did manage to admit that the rock hard knot that appeared at my calf muscle immediately after the injury was likely my tendon. Since I could rotate and weight bear on the foot, obviously it wasn't a severe injury though.

I quickly found an excuse to get out of track, despite the familial expectation that EVERY child of my father's was supposed to run track. I took an afterschool babysitting job that conflicted with track practice. Since the family was a member of our church, my father would not interfere and tell me no. This would appear as if he were a poor minister. It saved me from the torture and after that point I learned what my ankle was capable of, or not capable of forward.

When I was 30, I went to an Orthopedic surgeon, a friend of II's. I explained the history of my ankle injury to him and asked him what my options were. He estimated that I tore 80% of the tendon that attaches my calf to my ankle joint. Tendons do not repair themselves. The torn tendon is still there, balled up next to my calf and atropied. He could feel it, he could see it even. He stated unequivicably that I needed surgery to repair my ankle when I injured it, that it was entirely likely I broke bones in the ankle as well but they have since healed. At 13 and immediately after the injury, it would have been an easier surgery and a quicker recovery process. However, at 30, there would be nothing easy about the repair job. In fact, he would have to cut into my heel, reach up all the way to the calf, stretch the tendon back down and attach it, and since it 20ish years, the likelihood that the tendon can be fully restored is low, so it would require synthetic materials or harvesting tendon from elsewhere less critical in my own body. He could do the surgery but it would be painful, would have a long recovery in which I would be unable to walk, and it would have limited success to attempt it. Instead, he recommended that I continue to baby that ankle. Since I can walk on the 20% tendon that exists, I should continue to wear braces and to always listen to that burning sensation and never stress the ankle. If I ever tear that tendon even a little bit again, I will have no choice but to have the surgery to repair the injury. Given the lack of medical care I had at 13, I am in a position where my body has compensated and it is functional the way it is. So, I opted to maintain status quo and take care of that ankle to prevent further injury.

I do not run. I have never run since that point. I don't job either. I walk. I can power walk if and only if I have built up to that activity. I can hike. I have a brace for my ankle. I have a deformity on that ankle where you can tell connective tissue is gone. The ankle sinks in. When I was 19, I distracted from this deformity by putting a tattoo on the sight--great for empowerment but significantly worse on the pain factor than even an ordinary ankle tattoo would be since it was needle directly on bone.

What I know about my ankle is that I cannot jump into exercise. I have to build slowly, strengthen the muscle to compensate, utilize my brace especially as I am building up ankle and calf strength. If I do not do this, and even as I am doing this, the ankle burns again. This is not a no pain/ no gain scenario. I cannot push through that pain. I have to slow down. I have to do lots of flexibility exercises. It takes a couple of weeks as I am restarting exercise to build this ankle back up.

When Micah was dying, I started walking. It built that ankle up and it did not bother me again. While I slacked off on the exercising after Micah died, I started a job where on the days I worked I averaged two to three miles of walking per day. This continued to strengthen my ankle so I didn't have to think about it anymore. Then, I quit my job first of December in preparation for this move and I wasn't walking there. It was too cold and snowy to walk in New England so I wasn't exercising outside of work either.

Today, I started walking again. This new neighborhood is a lovely place to live and it has terrific resources for walking. However, those paths are hilly. Having not exercised for six weeks, the burn came back quickly. So, I managed to walk 2/3 of a mile, with several stops to flex and rotate the ankle as I went. It's a slow start. It would be discouraging, especially since I was otherwise find with the exercise, including my breathing struggles. However, I know my ankle, and I have done this before. I will dig back out my brace. I will start doing strengthening exercises at home and at rest and I will start with less than a mile. I will build back up again and get back into exercising.

The chaos of the fall has died down finally. We are moved. We are stable. The children are slowly and steadily launching into their new schools, new lives and new normalcy. It is time to start working on my health and exercise as well. I love that this time I simply know to build back up and not give up. I know that it is important to take care of me and my health and not merely everyone else. I know that this will take time, but I cannot be discouraged. Instead, I can rejoice that despite the horrific injury done and the terrible harm done by a woman who called herself a mother, I can still walk and what I require is not pain management, not surgical restoration but physical therapy techniques that I am well familiar with and soon I will be walking strong again.

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