Ankles

-------------Long Post Warning------------------

I was doing Pilates this morning and as I did something with my legs in the air (never a good look on a Sunday morning) I realised how bony my ankles and feet look, and how misshapen my left ankle really is. So, on that theme I'll try again, with the story of the moment when I thought I'd never exercise again.

As I said in a recent post, I was always fairly active growing up, but not too interested in organised sport. I always half thought about getting fit but never quite got round to it. I was probably in a thinking about it phase over Christmas 2002.

It was my first Christmas in Gran Canaria after my family moved there, and I'd had a great time. I was due to fly home on the Thursday after New Year because the works Christmas party was on the Friday (for some reason they always used to have it after New Year). That party was legendary, free drinks all night, free hotel rooms, the entire firm from across the country in one place for one evening only, and worth flying home for.

My flight was about lunchtime so I'd had a leisurely morning. I'd driven to the supermarket to pick up some stuff to take home, and I was all packed. My plan was to fly home via Madrid, get to Manchester late, stay the night somewhere between there and Leeds, go to work, drive down to the party, stay over night the next night in the firm provided hotel and then, finally, make it home on the Saturday.

My parents live in a row of tall, thin townhouses. The garage is set slightly down from street level with a slope going down to it, and with some steps going up to the front door which is slightly up from street level, on the floor above the garage. The steps don't open out onto the flat pavement, but onto the sloping driveway. This is important (and possibly dangerous, since the events of Christmas 2002 the landlord has changed the layout of the steps on all the houses he owns on that row).

I was all packed up so I carried my bag out to the car. I think my mum was on the roof terrace putting out some washing. As I got to the bottom step, my ankle gave way. I always used to go over on my ankles when I was fat. This is something I've not actually done for a long time, maybe I'm putting less strain on them now, I don't know, or maybe my ankle was just inherently weak and is now stronger due to the events that followed. My case was nice and heavy, filled with christmas presents and cheap alcohol, and I had no chance of keeping my balance as my ankle turned, on a sloping surface and carrying a heavy case. Over I toppled. I remember very little about how I landed, but I think that my case must have landed on my leg or ankle somewhere and caused it to bend in ways it wasn't meant to bend.

My cry was audible from the roof and the end of the row. My mum came running down, as did the English neighbour. I'd managed to get myself into the seat of the car by this point, without fainting, which was actually quite an achievement. It was a little comfier than the floor. Within 30 seconds of falling I knew exactly what I'd done. I didn't nee doctors or x-rays to diagnose it, it was obvious. Still, the English neighbour convinced herself that it wasn't broken because I could move my toes. I tried to convince myself that maybe it wasn't so bad. But failed.

Being resourceful (and having all my documents to hand) I decided to phone my insurance company straight away. And got nowhere. Apparently I needed a doctors certificate to say I wasn't fit to fly before they'd look into getting me a replacement flight. I tried to persuade them that as my flight was in two and a half hours, I would miss it purely by attempting to get a doctors certificate, but no, they couldn't do anything.

By this point I think the car was being driven to the local hospital. No sensible thoughts like calling an ambulance or going to the nice, multilingual, private place. Oh no, we went to the local state run place. Got to the car park and instead of dropping me off at the entrance my mother, in her infinite wisdom, decided to find a parking space first. It was busy, of course, so I then had to hop across the car park. I had acquired some crutches by this stage (my family is the sort that always has crutches lying around, at the moment there is a pair in the back of my car for some reason), but I wasn't used to them and there was frequent foot-ground contact which hurt like hell.

I got to reception, and got to stand up while my mother argued with the receptionist in very bad Spanish. Apparently I wasn't allowed to be seen there (or seemingly even be offered a seat) because I was a tourist. Never mind that I had my E111 which entitled me to treatment, or that it was the closest hospital, it was for locals only. Don't you just love equal treatment of EU citizens... I finally got to see a doctor there who followed my diagnosis approach and said it was broken without needing an x-ray. I didn't really expect to be told anything else, and although there weren't any bones poking out, it was blatantly obvious. I (finally) got a painkiller (and even more blissfully got to lie down while they administered it) and then got sent on my way. Not because I was a tourist this time, but because I needed to go to the big hospital in Las Palmas where they dealt with this sort of thing. I only got the jist of this with my very basic Spanish, but was quite worried by the use of a word that seemed to be surgery. That was worse than I expected, and not overly promising.

So I got bundled back into the car, and we went to pick up someone Spanish who might be able to translate (might have been useful to think of that earlier!) on the way to the other airport. By this point my mother is banning me from eating in case I need surgery and I'm wilting in the heat. The pain has abated a little, but only a little. We had to argue to get close to the hospital in the car, the guards wanted us to park miles away, but one look at the ankle and they let us into the ambulance entrance.

I got out of the car, and seriously by this stage it was disgusting enough that people would turn and point. It was swollen up to roughly the size of a football, and was very clearly not right. Not right enough that I actually got a wheelchair to sit in for my stay in this hospital. But not quite bad enough that they managed to write the right thing on my x-ray forms. Completely oblivious I got to x-ray to be asked why my right knee needed to be x-rayed when it was clearly my left ankle that was the problem!

X-rays in hand, I got taken back and plastered up. No mention of surgery now, which at least sounded more promising. Until I discovered they were just deferring it. The doctors wanted me to fly home and be operated on at home, on the basis that I'd have physio at home and it would better be done by the same hospital. At the time I was gutted, I quite fancied a prolonged stay in Gran Canaria with my family rather than facing an English winter on crutches alone. But with hindsight I'm not sure I'd have fancied being treated there...

I got sent on my way with a cast on my ankle, some drugs to take and very little advice. Was I meant to keep weight off it? Was I meant to keep it up? What the hell was wrong with it? No idea. I got carried back up the steps into the house (poor Eduardo's back has never been the same since...) and back to the battle with the insurance company. They would cover repatriating me, of course, but the problem was logistical. It was the weekend at the end of the Christmas/New Year holiday. There were flights off the island, but they were all full. Eventually I managed to get some seats going via Amsterdam, and my mother who decided to come with me on the basis that I had no-one at home to look after me had to pay full price (£1000) for her seat as the insurance company didn't see that as a good enough reason. The flight was on the Sunday, and on the Saturday someone asked whether I had a fit to fly certificate. A what? The hospital hadn't given me any paperwork really, and certainly not any sort of certificate, although they'd provided medical reports to the insurers to validate my claim and say it was medically necessary for me to go home.

So off round the hospitals we went. The state system said that no-one other than the doctor who originally treated me could sign a certificate. Which wasn't much use at about 10pm on a Saturday night, 10 hours before the flight and when he wasn't on duty. So we tried the private hospital and wondered why we hadn't gone there in the first place. A bit of money changes hands and they'll sign anything.

I woke up on the Sunday morning and wondered whether I actually was fit to fly. There was a patch of blood on the outside of the cast. I tried to calm down. When I fell I'd scraped the toes on my other foot, and told myself that I must just have knocked a scab off in the night and transferred blood onto the cast like that. I tried to ignore it and not think too hard about where it was coming from.

We got to the airport. I had 3 seats and my mother had one. The airline wanted to seat us in 2 blocks of 2 seats. Fantastic. We managed to hold up the check in queue for about 20 minutes until they actually found us some suitable seats, then dashed through to get on the plane. I think I'd located a wheelchair at the airport, having had my borrowed crutches taken off me at the door to the airport so they could stay in Gran Canaria. I hopped up the steps to the plane (the best aerobic workout I'd had for a while!), and collapsed onto the seat.

At Amsterdam the only thing I could think about was that the patch of the blood was distinctly bigger than it had been earlier in the morning. That's one of those things that you know instantly is NOT GOOD. I've never been as relieved to see Manchester in my life as I was at the moment when that second plane touched down. But the stress wasn't over. Waiting at baggage reclaim we quickly realised that our bags weren't coming round on the belt. The wheelchair pushing bloke who'd been sent for us quickly worked out what had happened, apparently Amsterdam is notorious for hanging onto bags for longer than it should. We registered our claim, and headed outside to the waiting ambulance.

I got to the hospital, and no matter how bad I thought it was, I wasn't prepared for what happened when they took the cast off and did their own x-rays. It turns out that not only was my ankle broken in two places (which I hadn't been told) - both the bones, but it hadn't been put back into position when they put the first cast on, and the broken jagged ends of bone had cut off some blood vessels, which had burst, caused the surrounding skin to decay and generally done bad things, which was where the patch of blood had come from. The swelling hadn't gone down at all over the past three days, and there was no way they could operate for another five or six days.

This is the point at which my mother in particular got particular panicky. She was convinced that they'd need to amputate my entire foot. Phrases like "we'll see what we can do" and "what on earth did they do to this?" aren't calculated to inspire confidence, to be fair. I was never quite so pessimistic, but came to realise that it was a horrible horrible break, made worse by the "treatment" I'd received, and that I'd be lucky if it ever recovered properly.

I spent until Friday lying on my back with my leg in the air. I've rarely been so bored in my life, surrounded by all the old women with their winter slipping injuries, broken hips etc. The orthopaedic ward is a barrel of laughs, believe me. I was scared shitless at the prospect of surgery (I'm a wimp about that sort of stuff), and I was gutted about the amount of damage I'd done to myself.

The operation and the weeks with the cast on passed. It all went so slowly. My upper body strength got surprisingly good, hauling the lump of my weight round on crutches, but I wondered whether I'd ever be able to walk properly, let alone run. Not that I could run before, but I'd always intended to start, and now I didn't think that would ever happen. Physio was a slow, painful process. When the cast came off my ankle was still horribly swollen, immobile and even better covered with scars. They'd had to cut both sides of my leg to get all the metal work in, and I couldn't believe what a mess it was. The patch of decayed skin still looked tender, the scars looked raw, and my ankle looked like it should be half the size it actually was.

I slowly started to walk properly, but gave up all hope of it being normal. A year passed, which was when they said the swelling should have gone down by, and it hadn't. (Two and a half years later it still hasn't). But it started getting stronger. I got more confident, and I started to think it might be normal again after all. I started to exercise, fairly cautiously at first to avoid injuring it any more, but then properly. It flared up when I first started to run, and for a week or so I could only put weight on my left foot very cautiously, but since then it's been stronger than ever.

And what's more, I think that the exercise will help me never do it again. I don't think that ankle will break again, not with all that metal in it, but I was always worried about my other bones. I know a fair few heavier people, and the funny thing is that of all the people I know it's the big people who've had serious injuries from innocuous objects. A suitcase, a leaf, a boat, a gravelly slope. I'm no doctor, so I don't know whether it's just a coincidence, whether it's extra stress being put on the bones or whether it's the effect of the weight putting strange pressure on the bones as we fell, but we all broke in our own ways. Maybe it is a coincidence, but since I started losing weight I've become more balanced. I don't go over on my ankles any more, and if I do trip on a paving slab or something else I regain my balance before I hit the floor. That has to be an improvement from the constant grazes I had on my legs in the past.

So I still have a misshapen ankle to prove to me what I've been through. I think the experience helped me because it forced me to put up with pain, with not being able to do what I wanted to do, and with facing my fears. That's been invaluable in other ways, and I'm proud of coming through it stronger and fitter than ever.