The Dreaded Ankle

I've mentioned several times that I am recovering from ankle surgery. For posterity's sake, I should record, to the best of my recollection the short history of Vic Kaiser's right ankle problems.

My earliest recollection of something being wrong with my ankle was the Spring of last year (2004). As I did every spring, I was flirting with getting in shape and losing weight. This always coincides with my birthday for some reason. I started walking 3 or times per day. As happened every year since I was married and had kids, though, I soon lost interest, this time, partly because of a nagging pain on the side of my foot. I didn't really pay it much attention. For the rest of the spring and summer it was just there.

While interning at UT-School of Health Information Sciences during the summer, I spent a lot of time around a bunch of cyclists. Also, had a physical and my fasting sugar was creeping up, a sure sign that if I didn't do something about my weight (365 lbs.), all kinds of problems were just around the corner (e.g. adult onset diabetes/insulin resistance). So, since I couldn't afford the bike I wanted, I decided I'd run.

Back to the ankle...I started a walk/run program. After 7 or 8 weeks, I became acutely aware of my ankle hurting constantly. It wasn't enough to put me down but it was sooooooooo annoying. I joined Power in Motion (PIM) and it was there that I got hooked up with Dr. Ed Kieke of Koala Health and Wellness Centers here in Houston. Here's where the fun begins and I must be concise.

I began visiting Koala Health and I can tell you, they are great. The staff was so knowledgeable and friendly. Dr. Kieke diagnosed me with tendonitis of the peroneus longus and peroneus brevis tendons. The course of treatment was to get rid of the pain and inflammation and then rehab and strengthen the calf and shin muscles on the cybex machine. During those many weeks of 3x per week visits with ultrasound, electric stimulation, massage, stretching, and cybex, I was miraculously able to keep progressing in my running. The treatments really kept me 'in tune" and able to run.

At the end of treatment, I basically had new, strong, healthy lower legs but this was short-lived. Not long after I stopped treatment, the pain returned. I went back for a couple of visits but Dr. Kieke suggested I see a podiatrist and get fitted for orthotics. I did. It worked for a couple of weeks but I regressed even further. My podiatrist finally said he would try a steroid shot right into the tendon, actually between the tendon and the sheath. If it was just inflammation, the shot would knock it out. If the pain returned, then there were probably other problems (e.g. ruptured tendon) and he would order an MRI. After the shot, I FELT AWESOME!!! By this time, I was out of commission with my running but the shot gave me new hope. I went out and did a few miles and WOW!, what a feeling. No pain at all. This lasted about 10 days. Then the pain came back, even worse.

MRI time. The results of the MRI showed an osteochondral defect of the posterolateral aspect of the talar dome. Dr. said this was causing instability in the ankle resulting in inflammation of that tendon. The radiologist reported no tendon rupture. Dr. Schnell, the podiatrist, said the surgery to repair the cartilage involved going in arthroscopically and removing the defective cartilage. Then they would scrape away any dead cartilage and drill holes down into healty bone. The bleeding would form a matrix for new 'fibro-cartilage' to grow back. One problem, he didn't perform the surgery. So, he referred me to a colleague, Dr. Beckman.

Dr. Beckman scheduled the surgery for the following week, thankfully. He did, however, want to look at the MRI. When he saw it, he suggested to me that the tendons looked 'kinda funny.' He wanted, while I was on the table, to cut open the ankle and just take a look at the tendons. Worst case, they're not ruptured and I'll just have a scar. Best case, he finds that they are ruptured and can fix them.

Well, Dr. Beckman fixed the cartilage but also found that the p. brevis tendon was sliced longitudinally along the entire length of the tendon. Also, the p. longus was frayed. This was all caused by a bone spur which he also found during the surgery. So, he filed down the bone spur and repaired the tendons. It was pretty major ankle reconstruction. I asked him how he got to the top of the talus to fix the cartilage. He said that they actually dislocate the ankle. They kind of just pull it out of joint to get to where they need to get to.

Recovery - After surgery, I was non-weightbearing for 6 weeks. That really sucked!!! Crutches, no driving, just terrible. Then I walked for a week in one of those hard boots, the ones with all the velcro straps. Little by little, I was able to start wearing tennis shoes. The whole time since then has just been painful, dealing with a lot of swelling.

So, my current status is that I am walking completely in tennis shoes. I'm back to full duty at work. And 2 weeks ago I started a jog/walk 3 times per week. This week, I'm jogging continuously (although very slowly) for a little over a mile. It still hurts a lot but is getting better daily.