Me and my IM Nail – Part 2 (3mths since the op)


<<< Me and my IM Nail Part 1

Me and my IM Nail Part 3 >>>

It is now April, 3 months after I had my accident and had an intramedullary nail (IM Nail) put into my lower left leg and 1 month after my original post. I’m happy to report that things are progressing well.

Two days after the last post I made it to the kitchen and back to my room without the aid of crutches. I was walking! Well, I say walking, it was hobbling and moving at the speed of a 150 year old man. I was able to put my weight on my bad left leg very briefly, maintaining my balance before my right leg would take over in a much more assured way.

Leg 3 Months on - I still have a bruise from the Tibia break and you can see the scars from the screws attached to the lower part of the IM Nail

I then made another attempt and I began to feel more confident in my hobbling. It was brilliant! Using crutches is so limiting and annoying it is extremely liberating to have both arms free and I have never had so much pleasure in making a cup of tea for my flatmate and was able to hold both cups of tea!

It wasn’t pretty, but it was technically walking.

Leg 3 Months On - The scars just below the knee are healing well but are still quite visible

Since that day, I have not used my crutches (except once to get sympathy from a delivery person). The progress was quite good the first week of walking and then has been slow and steady after that.

I initially practised walking around the flat and going up and down a couple of steps. The next test was to make it to my local shop and back (down 7 flights of stairs and a 50yrd walk) and it felt so good to be independent.

The next test was to go to my friend Alex’s house in Tooting (Yes American readers, there is a place in London called Tooting; British readers, Americans use the word tooting to mean farting) which meant a small walk and a bus ride. I passed both tests well and boy does that feel so good. You know you have a long way to go in terms of recovery but you know that you have got the worst of it over and you can resemble being vaguely normal again.

I'm not going to miss these

My mood had definitely improved and I was feeling very positive and could not wait to start my physiotherapy. This ended up being nearly 3 weeks after my last hospital visit due to some rather poor bureaucracy between St. George’s hospital and St. Thomas’s hospital. My postcode meant I would not have physio at St. Georges, where I had my operation, but would be referred to St. Thomas. I spent nearly a week chasing this up, not being able to get through to anyone who could tell me what was going on.

Then I got a letter from Kings’s College Hospital saying I could come into one of their open physio sessions on a first come first serve basis. I wasn’t sure why they had been in touch, but was pleased they had and was so looking forward to starting physio that I didn’t mind the hour and half wait to be seen.

The physio was really good and I was glad I had my x-ray photos on my phone as I was able to show him in detail what had happened and he said this was very useful. I was given a long bit of rubber (shown below) which looks like some sort of bondage sex aid. You use it to help strengthen the ankle muscles by pushing on it away, to the left, to the right, etc.

My Physio Aid

I mentioned to the physio I was a member of a gym and asked if I would be able to use any of the equipment. He said absolutely and seemed pleased I suggested the idea. He said that I could use the bike, the cross-trainer, the one where you push your legs together, the one that you push your legs apart and the one where you sit and push your lower legs up. He said not to go crazy, but it would all help build up the leg muscle again and help stop the limping.

He also suggested I slow down my walk as the quicker I walked, the more pronounced my limp was. He said slowing down the walk would get the leg used to walking normally (as a small part of the limp is psychological) and combined with the physio and exercises it would all help me lose the limp. The physio also said to listen to my body in the sense that if you are feeling intense pain, then stop and rest and don’t push it, but that feeling a little sore and having swelling is all very normal and part of the healing process.

I’ve been to the gym three times since the physio appointment and although I realise how unfit I have become it felt good to be able to do these exercises and be proactive in my recovery as the first 2 months I felt very passive as you have to be patient and concentrate more on healing and looking after your leg. I’ve had the flu unfortunately this last week so have not been to the gym, but I am still making progress.

Leg 3 months on - Scars below the knee

My walk still has a limp but when walking slowly it is not very noticeable, but I am able to get about just fine (buses, London Underground, stairs, walking about, etc.). I have found walking down stairs the most tricky and for the first couple of weeks I went down one step at a time (i.e. one foot on the step, then the other before moving onto the next step) but have progressed to walking down more normally but I do notice the transition from stepping down on my left foot to the right foot is a bit heavy and fast. There is still not quite the control and fluidity that should be there.

Walking long distances (more than 15mins) does take its toll. My parents came up to London for the day and I met up with them and we walking around for a couple of hours and although we were not walking fast, it did feel sore and my Dad noticed I was limping more by the end than at the start. My leg had swelled a fair bit and was sore that evening and the following day.

The improvement in the leg means sleeping is better as I can get into my more normal sleeping position, but still get woken up with a bit of pain if I have been lying on it wrong somehow.

I still have a fair bit of recovery to go, but feel good about where I have got to in 3 months, especially as I was told it would be 6mths before I could do all the things I wanted to do. I feel I have got over the halfway point.

Recovery does seem slow with only gradual improvements (e.g. you notice little things get slightly easier, like getting in and out of the bath shower, putting on trousers whilst standing and walking down stairs), but it is nice when friends notice you are walking better than you were a couple of weeks ago.

I have my next and suspect last hospital check up later in the month and it will feel very nice to give the crutches back. I will not miss them. I also think that I will be quite close to being as recovered and able as the guy I saw at my last hospital visit. He was able to walk quite freely and easily but had a very slight limp.

My next goal is to be able to walk without a limp at all.

<<< Me and my IM Nail Part 1

Me and my IM Nail Part 3 >>>



22 responses to “Me and my IM Nail – Part 2 (3mths since the op)

  • Me and My Intramedullary Nail « 21st Century Boy

    […] Read ‘Me and My IM Nail Part 2′ – (1 month after this post and 3 months after the … […]

  • Dave Datalayer

    Glad to hear your’re mending, you’ll be moonwalking (dancing) and caterpillering soon..

  • Terry

    Hi Jake,
    just read part 2.
    You are very strong willed and optimistic. I see I have a lot of hard work before me…
    Keep us informed.

  • Jean Summers

    Just found your blog and found it very interesting and also very encouraging. I too have had the same operation 5 weeks ago, and am finding it now very tedious not being able to do much for myself, when I am normally a very active and independent person. But I see I have a way to go yet before I can walk again. I am not allowed any weight on the right leg and cannot master the crutches, but have a walking frame instead, and a wheelchair (from the Red Cross) both of which have been my life savers. It’s interesting to see what lies ahead for me, from your experiences and yes it is a serious break (tibia and fibula) so should not expect it to be fixed in such a short period of time. thanks anyway for your encouraging report. Regards Jean Summers

  • di

    Hi there, I m thrilled to find your blog. I have a very similar case to yours, but with the added bonus of an open wound.(sort of medieval hit and run involving horses instead of cars) . Any way, when I left the hospital I knew absolutely nothing , I was in horrendous pain ,so asked nothing and was told even less . I have gradually gathered information and here is where I m at 8 weeks after surgery. .. I am pretty much bed bound, and after my check up today , I am to start physio straight away because my circulation , well, is very crappy . I have nerve and artery damage to add to my original list of broken tib and fib plus a nice big nasty open wound. I have about 5 minutes on crutches before my foot turns blue , 10 minutes and I m lying down with my grape like toes in the air …. gravity is not the best way ,but its my only option at the moment. WARNING TO OTHERS IN THIS POSITION…. keep wiggling. Your toes from day one , kinda scrunch them up , count to five and release . Another thing …. if you are a sportsperson , do get a second opinion as whether to have nail removed or not … the original hospital I was admitted to pretty much said, no way , second opinion . Who actually asked me questions about my lifestyle !!!!! Said I would be safer having it removed at a later date, (high risk of recurring injuries ) . Also at my second consult, I was much less shocked and learned what to expect. First time , I couldn’t hear any thing over the little voice in my head screaming, no howling.. get me out of this hospital now!!!

  • Ross

    I read your 2 months post op article, I had the same procedure done and was wondering about recovery time as well. It helped me a lot as to what to expect in the up coming weeks. Thanks a lot.

    • jakemcmillan

      That’s very kind of you to say! Hope you recovery is going well?

      • Ross

        Slowly but surely. It’s only been three weeks today since my surgery. I hope to be up and walking (limping around) in about three months, I’ve been doing a lot of walking putting minimum weight on it and the ankle exercises, which my doctor also suggested.

  • Babs Wright

    Finally! Something to read – post op vs. those UTube videos I should not have looked at pre-op. Terrifying, even if it was the reality I was facing!
    I started with undiagnosed stress fracture for 6+ months. Phys Therapist finally sent me to the right ortho guy who took the right xray, and put me in cast, then walking”boot”, then after 6 months of his initial diagnostic xrays revealing “the dreaded black line,” then followup CATscan showing “non-union” of fracture – with an additional one above the original one he had seen, decision was made to “rod” me. “Non Union” and “IM Rod” were equally scary terms. But I’m tough, had it done 10 days ago, and finding it tough to be tough right now! Thank goodness for my mate who has really risen to the call. Neither of us realized the dibilitation would be like this. Now as I read your account, the road ahead to “normal” will be a little longer than I anticipated. Guess I didn’t ask doc right post-questions. Doc has been great, but am really anxious for Mon am appointment to see xray of my not-so-friendly new tibia resident. Doc will also discuss future of additional stress fracture in other leg! This one appeared as he prepared for surgery to check out my complaints of pain in both legs! Right leg that is also suffering because of my dependence upon it as I use “walker” and poor attempts at crutches. Still maintianing optimism about the whole thing, though.

    So far, “elevated and iced” are pretty confining positions. Doc also has me using an ultrasound device for 20 min. daily over fracture site “to promote bone growth. (“Exogen Ultrasound Bone Healing System.”) Sounds a little psuedo-science, but placing faith in doc’s advice.

    My contributing factors are osteoporosis diagnosed AND treated for maybe 6 years, possible leaching of calcium from several prescription medications. Lactose intolerance since childhood for many years is probably largest contributing factor – plus my very-young age of 63! (no, I AM NOT old!!)
    Also l see endochronologist next week to see what he recommends to repair and prevent future issues related to osteo.

    Thank God for good insurance as I’m in Mobile AL in USA, so, yes, I have to depend on insurance coverage for this very expensive process to get me walking without painful limp(s), and especially curing the cause. YES, the American healthcare system is broken and needs fixing asap, but that’s another epistle/frustration, etc. Again, counting my blessings for being in a position to have the procedure covered by insurance.
    Thanks for sharing your experiences! (I finally put the right combination of words into Google to find you!) Best wishes to all of you in your continued successful recoveries.
    Thanks especially to you, Jake for your initiating this whole blog. (You share my partner’s name – a lucky thing!) I now feel I have a better picture of what lies ahead for me. Sounds like it will be slower than I had anticipated, but reading here will prevent me from thinking I’ve done something wrong to be healing more slowly than anticipated. Looking forward to getting back with my wonderful physical therapist who sent me to the right doc in the first place.
    I’ll also be able to give my boss a more accurate picture of my situation when I am permitted by doc to return to clerical job.
    Babs

  • Suhayle Master

    Hello mate, I am currently recovering from IM nail surgery. I have to thank you as i discovered your blog in the first week and it really gave me an insight of what to expect. I have done all the things possible to speed up recovery – eating/ drinking right things, early mobilisation etc. I am at end of week 5 since surgery and can say that I have just started walking without crutches. And it is an amazing feeling. Made my first cuppa today and transported it to living room without spilling! I have been doing my own physio as I noticed your appointment took ages and it has really helped. Only issue I have is that my knee hurts a bit and feels quite weak when walking. I feel it may be an issue with the patellar tendon healing correctly as they have to slice through this during the surgery. Did you have this issue? Don’t forget I have virtually no muscle wastage as I had a cast for just 3 weeks and was partial weight bearing from week 3. I just have very stiff ankles and calf muscles. I use your blog as a reference point in my own recovery so it has been absolutely invaluable for me!

    • jakemcmillan

      Hey! Many thanks for the comments, much appreciated … makes me glad I took the time to write it all down! Sounds like you are doing really well and doing all the right things … I do remember that feeling of making my first cuppa without crutches, it feels like freedom! I don’t remember particularly having an issue with the knee, although it was definitely a bit sore and weak, but my main issues were more around the ankle. Best of luck with the rest of the recovery!

  • Sazofraz

    Did anyone have pain for the first month that they walked without crutches? I broke my f + b on 4th July and it is now mid September. When I was walking with crutches I didn’t have any pain and was off pain killers, Now I need two types to enable me to walk without crutches. My GP thinks the pain should have lessened by now,not increased. So it would be good to now if what I am going through is normal.

  • Sazofraz

    HOW TO KNOW IF YOU ARE DOING TOO MUCH
    The Principal Physiotherapist who I am now seeing has told me that I am doing too much if the pain doesn’t go away within 20 minutes of stopping the activity. Also I am doing too much if the swelling in my ankle hasn’t gone down by the following morning. I wish I’d known before when I apparently overdid things. Don’t mask the pain by taking pain killers which I what I did!.

    • suhayle

      If you are taking ibuprofen i would stop it as it interferes with the body’s natural inflammatory response. I am at week 12 and my leg still swells during the day but is ok in the morning. Hoping to be running by week 16!

  • Richard Seldon

    Hi mate. I’m sitting in my hospital bed the day after the exact same op. Can so relate to everything in your first blog, especially the toilet bit!!! Trying to wee in a bottle on a ward is nigh on impossible.even more annoying is the toilet is 5 yards to the side of my bed but they wont let me get up!!! Had my op in the morning and the rest of the day was a bit of a blur really. They said it would be about 3 hours but struggled in recovery with my breathing a bit so was out for 6 hours. Weird as im normally a fit and well 39 year old. Just gunna read the rest of hour blogs now to see what I’ve got to look forward to.

    • richard

      2 weeks now since my op. Had the staples removed yesterday and doc was really pleased. Said to start putting weight on it now but still too weak to really put any on it. Told I can go back to work when I want to on light duties. Work in a factory and work have been good and said I can go in the office until fully fit. Have to really as cant afford longer off as only getting statutory sick which is £80 a week. Would have got full pay but as I broke it playing football im not covered. Should have got drunk and fell down stairs thenni would have got payed!!! Anyway cant believe how quick I seem to be recovering. To look at apart from the ctutches you wouldnt know anything was wrong. My only worry is the bottom of my foot is still numb but doc says feeling should come back in time. Get little aches and pains where the break was and screws are but to be expected I suppose.

  • Steve

    Thank you for writing this article, it contains some really insightful information is not otherwise available.

    I’m now 7 weeks post op and suffered very similar breaks to both tibia and fibula. Things seem to be going well and I’ve been full weight bearing since my check up last week. This evening I am experiencing some irritating feeling from the fracture site, somewhat prickly, but only when load is put onto my leg. I’m concerned I may have done too much.

    Did you experience any unusual sensations after weight bearing commenced?

    Thanks for assisting and kind regards, Steve

  • Mpho

    Hi Jake,

    I enjoyed reading your blog. I am from South Africa and also fund your blog to be re-assuring. I am 5 weeks past the same surgery. I was not sure what I can do or not do with my foot.

    Thank you very much!

  • Don McClellan

    Thank you so much for sharing your experience! I’m currently 3 weeks post op. and am so grateful I found your inspiring story. This looks to be the hardest thing I’ve ever dealt with, even considering I have Type 1 diabetes. I actually had the same fracture in my left leg resulting in an IM nail. Like you I also saved a blind man and pregnant woman from a train😉. Ok, I lied, actually I got 20 feet down a bunny hill on cross country skis before I twisted my leg into a spiral tibia fracture.
    So far the swelling in the ankle is the worst and doesn’t allow any movement in the joint. Your blog has given me more reassurance than all the medical articles I’ve read and has given me hope. This has been a mentally exhausting. Thank you so much!

  • lettertomum

    Thank you so much for this blog! I fractured my tibia in February and the last two months have been challenging to say the least. My experience seems to mirror yours, so i hope to continue to recover as you have!

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