Road to recovery looks now to be longer than I hoped. My most optimistic hope was probably naive.
Essentially, almost 6 months from the accident, my bones are healing—strong enough for stationary standing weight but not necessarily strong enough for walking unassisted or climbing stairs. As can be seen from the recent X-rays taken ninety days after weight bearing, I overloaded the two lower screws in my right femur, breaking them, The bone is still stable and the doctor indicated it actually may be beneficial in accelerating the bone fracture healing. It does however change the plan to assume I have one “good” leg and I now have to take care to not overload either leg. Time will tell, and pain levels will indicate if there are complications.
Now, the use of only one cane is no longer advisable. Mobility will require my rollator or two “forearm” canes sometimes referred to as Canadian Crutches or Lofstran Crutches. I will also try using two StrongArm canes.
https://youtu.be/DV_9dbCmeFs
I can actually walk without any mechanical aids but it overexerts my bones and muscles leading to high pain levels.
Using the “aids” puts considerable stress on wrists and arms as well as shoulders. The “gait” chosen affects this stress/load. In addition, the shape and padding (if any) affects the stress. The rollator I chose had a special handle shape and stress is relieved by the suspension springs. The StrongArm cane uses a foam pad. The Drive forearm cane comes with a relatively stiff and small diameter handle-I modified with padding and an asymmetrical shape to reduce stress. I am alternatively using all three of these devices. Each has their own disadvantages and advantages.
The rollator Walker or the Forearm Canes allow me to walk with a relatively normal gait using the aids to limit weight bearing to each leg carrying half of my body weight.
My new goal is to be walking with no aids by the end of August—four months from now.
26 weeks out—6 months from accident! I have recovered from the tendonitis in the right leg. Walking 1/4 mile daily using Rollator. Walked almost 1/10 mile using forearm crutches. I call the crutches my “sticks”. Technique using the “sticks” affects the load placed on each leg. Moving both together is a bit less load. Moving “4 point” or each stick moves alternately in unison with opposite leg loads legs a bit more. A bit concerned about broken screws in right leg’s titanium rod, so I am being careful not to overload the right leg—and also being careful to not overload left leg that has many more repairs. I am walking short distances in the house with no assist devices.
Range of Motion on left leg has improved to 105+ degrees and now using air bike starting at 3 minutes daily. My full exercise regimen daily takes about one hour. Most everything done in bed except the strength exercise for hamstrings is done in a chair.
Have completely withdrawn from Oxycodone. Pain relief is now down to one 100mg ER Tramadol and two Ibuprofen per day. Back to one oz. Bourbon before bed for sleeping. Will move to 50 mg Tramadol dose at end of May and then withdraw from that gradually. (50 mg Tramadol is equivalent to 5 mg Oxycodone.)
Getting ready to try hitting golf balls. Will use a modified “arms only” technique. See “85 year old man swing” video. I belong to Bon Air Country Club-using driving range is easy-parking is close and free balls are at the tee mats. When I want to play on the course, the Pro Shop will deliver an electric riding cart to me and give me a handicap flag allowing me to drive closer to greens.
Mother’s Day weekend, two restaurant visits with our different son’s honoring Carol on Saturday. Quite a bit of walking. Used forearm crutches. While returning home after the second restaurant visit, I experienced severe 10/10 pain in right leg. Suspect a stress fracture somewhere related to issue of the broken screws no longer providing support. No pain up to 120 pounds on leg—severe pain if more weight is applied. So standing causes no pain. Moving with partial weight bearing techniques.
Very discouraged and depressed. Hopefully additional surgery will not be required. But in any case it looks like a very long time before returning to anything close to “normal”. Healing of complex comminuted fractures is very slow-especially for old man. Schedule with doctor and X-rays on 5/16.
X-rays showed no change since 4/25. So continued weight bearing is recommended but not so much as to overexert tendons, and recognize that bones are healing slowly—a more realistic recovery time to walking with no aids is probably October.
Now more than 6 months from accident—able to walk but need to use crutches or Walker to reduce weight due to pain.
Although the tendinitis in right leg’s quads healed, I continue to have pain on inside (medial) of right knee just above the joint. In addition when full weight bearing, I feel a form of pressure discomfort. I am now convinced it is related to the Sartorious muscle that is weak and becomes sore when weight bearing for a considerable period. (A weak sartorious allows the knee joint to rotate while bending.) see video for exercise and stretching.
I tried to go without any Ibuprofen for 24 hours but had great deal of difficulty sleeping. Will go back to two 200 mg per day for awhile.
Now more than 7 months since accident. Slow progress. I can walk short distances without Walker, longer with one cane and about 0.4 miles using Rollator. Without a cane or Walker, my knees feel very stressed and become inflamed—. Ice pack helps. Still have pain from inside right knee.
Have completely withdrawn from all opioids-quit Tramadol. Withdrawal symptoms were significant. First day I could not sleep. Took 25 mg. Still significant insomnia, but improved each day. Symptom free after 5 days. Able to end laxative Miralax.
Medication now is two Gabapentin and two Ibuprofen each day. One 325 mg aspirin and fish oil capsule. Am taking vitamins C, D3, Zinc and Tumeric. High protein and calcium diet. Physical Therapy once per week. Newest exercise is the beginning squats. Daily routine is almost one hour of leg related exercise. Using Airbike 3-4 times per week.
With new Kohler walk-in tub shower installed, daily hot bath with shower spray focused on knees is helping. Still, progress is unbelievably slow. Seems like attempts to accelerate strength recovery results in excessive inflammation and sometimes tendonitis. Based on pain during squats and sit to stand from seat height less than 26 inches, as well as 50% of leg lift strength, considerable development of quadriceps and connected tendons is still required. Beginning to think issue is not just atrophy due to time without weight bearing but also some residual trauma damage.
Took a week to recover from the 10 sit to stands done over 30 seconds and 24 inches. Able to reduce to only one Ibuprofen per day. Tried going without and suffered in morning.
Using heat therapy now. Still a bit of discomfort but it may be a form of post trauma arthritis. Left knee pain is related to protruding screw in femur like a bone spur dragging on soft tissue. Scar tissue in left holding range of motion to 105 degrees. Tolerable with daily Ibuprofen. Walked 0.4 miles using one cane. Using one cane inside home. Can walk without aids inside home for very short distances.
Walking normally at normal speed, pain free without aids in October still seems to be reasonable goal. Looking forward to next X-ray follow up on July 11.
Great news from the July 11 X-rays. Significant bone growth since April—now there is continuous bone entire length with some growth to come later on the opposite side. Reasonably safe to increase strength training to build muscle and toughen tendons as well as continuing efforts to break up scar tissue.
Muscle development since first weight bearing in January. Left calf has increased 15%.
Almost 9 months since accident; 6 months after first full weight bearings. Range of motion in left knee improved to 110 degrees. Very slow muscle development despite 30-40 minute daily leg exercise regime and weekly PT. Concentrating on additional muscle development of gluts and gradual squats as well as lunges. Walking 3-4 miles per week—almost 4 tenths of a mile per day using one cane or walking inside Home Depot using cart. Trying to avoid overuse or excess stress so as to avoid tendonitis.
Observers claim my gait has improved. Pain pretty much now only related to inflammation from stress on knees-and quads. Can navigate steps with cane and railing. Curbs without railing are a challenge. Amazing how much pain above knee when pushing up at max leg stress to navigate up steps—only possible with considerable help from arms.
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