Friday 18 November 2016

ME AND MY NEW ANKLE - 18 MONTHS ON

It is now nearly 18 months since I had my ankle replacement at the Royal National Orthopaedic Hospital (RNOH) as part of the TARVA trial and, I am horrified to find, also almost a year since I last posted on this blog.

So, not before time, here is an update on all that has happened so far as me and my new ankle are concerned since the end of last year.

In the period between my three-month check in September 2015, and the six-month one scheduled for early January, I continued to gradually wean myself off the air cast boot and with intensive exercises, guided by my physiotherapist, all of which I referred to in detail in my last blog.

So, by last Christmas, I was no longer using the boot at all, and concentrated on continuing to strengthen the ankle and learn to walk properly again.

My six-month check at RNOH was the briefest I have had - Mr. Goldberg was not there himself, so on this occasion I saw his Senior Registrar, Karan Malhotra, who was happy with progress and who said he was happy for me to start (gently at first) back at golf. I also as usual spent some time with Deirdre Brooking to complete the regular questionnaire that is an essential part of the TARVA trial process.

March brought a big personal milestone for me when I was able, for the first time, to complete a full round of golf - it really brought it home to me as I sat with a drink in the golf club afterwards what a huge difference the ankle surgery has made to my quality of life. I followed this up in April with several rounds of golf over the space of ten days when I got together with my golf-mad brother - the ankle was gently protesting at the end of that, but nothing that didn't disappear with a couple of days rest.

I continued with visits to the physiotherapist until the end of May - whilst we had discontinued individual sessions working directly on the ankle in March, I continued to go to the physio gym twice a week where she supervised a series of exercises designed specifically for continued ankle rehabilitation and strengthening.

This I continued until just before my 12-month check at RNOH. We did quite a number of X-rays on this occasion, including the technically very advanced procedure of taping a paper-clip to my knee to identify (I'm guessing) the top of my fibula for an X-ray!!

With the X-rays complete, I then got in very promptly to see Mr. Goldberg who pronounced himself pleased with progress, and then the usual session with Deirdre to complete the esssential questionnaire.

Three days after seeing Mr. Goldberg, I was stepping off a plane at Preveza and, gingerly, onto a 12 meter yacht in the Marina at Lefkara in the Ionian. A week under sail was to prove the ultimate test of my new ankle, as not only is sailing a yacht quite physically demanding, but it really calls for a keen sense of balance, especially when on the side decks/foredeck under sail.

It did take me a while to find my "sea legs", but I think that was as much about not having sailed for three years (because of the ankle arthritis) as anything - it was clear to me that all the work I had done with my physiotherapist both on proprioception, and on building core strength was now really paying off.

Since then not too much else to report, except to say that I have been able to increase the endurance of my ankle considerably, through walking and cycling, and as well as another marathon golf session with my brother recently, and some fairly challenging walks with him. We have also joined a local walking club which has walks of varying degrees of strenuousness twice a week.

Thought you might like to see a photo taken just now of how my "new" ankle looks in comparison to its non-bionic brother!




So, again reflecting back on the last eighteen months (and remembering that there was a brief moment, just as I was being wheeled down to surgery when I nearly called a halt), I would urge anyone with significant ankle arthritis to explore via their GP whether a replacement or fusion might work for them, and if so consider participating in the TARVA trial - it's being done at quite a number of centres throughout the country now, and participating will mean that - like me - you not only get your ankle fixed, but you are helping to determine whether there is a significant difference between fusion and replacement, especially in terms of patient outcomes. I was one of the first to participate in the trial, and it gave me an extra sense of purpose in knowing I was making a contribution.

But most of all, it has immeasurably improved my quality of life in so many ways, and knowing what I know now I wonder why I ever hesitated.

Major developments aside, I will aim to add my next post around the time of my two-year anniversary.