‘The Broken Road’
Six weeks after the surgery, more x-rays were taken, which determined that everything had healed as it should. The tingling was gone, but the jabs of pain remained, and the foot was still numb. The hair on the right foot, as well as the toenails, grew quicker than on the left foot, and whenever I put the foot down, it immediately turned red.
The surgeon brought in a nerve specialist, who said if I had any feeling – which I did, as slight as it was – then it would recover. They estimated about eleven months. But I was now diagnosed with something called ‘Complex Regional Pain Syndrome’, which was to say that the foot and my brain were no longer communicating properly.
I was referred to the Physio Department, who instructed several new exercises – including draping a tea towel back and forth over my foot, just to re-accustom it to sensation. They also had me stand face-first against a wall, tips of my toes pressed against the wall, and then flex the knee to touch the wall. The left leg had no issue, but I couldn’t get anywhere near it with the right leg – my right ankle felt like it had been taped up. The physios also got me in a pool three times a week, and gave me an assortment of exercises to do. Gradually, as my leg strengthened, they allowed me to go to a local pool to do my hydro.
The physios monitored my workload closely, although it was always frustrating since the workload seemed so little. But they kept impressing on me the need to pace myself. My left calf ballooned up with muscle since it often took the brunt of my weight, but the progress on my right leg was torturously slow. For a while I walked with a cane, which made me think of the irony of watching House the night I was hit, and how cool he’d made a cane look.
Whenever I walked more than fifteen or twenty minutes, my foot would sear in agony, and I could literally hear it scream at me, Do not step on me. And it would keep screaming at me, screaming through my head until it was intolerable, to get off it.
Because of the Complex Regional Pain Syndrome, I was also given exercises to try to retrain the brain to reconnect with the foot. One exercise involved resting a mirror against my right foot, so that the left foot was reflected. This made it look like I had a healthy right foot. Then I’d move the left foot, perpetuating the illusion of a healthy right foot moving around. Another exercise involved a computer program, where I was shown a series of feet in unusual positions, or with the shots taken from unusual angles, and I had to guess immediately which foot I was looking at – left or right. Again, this was meant to help the brain reconnect with the foot.
Next came a meeting with a neurosurgeon, who was fascinated by my Complex Regional Pain Syndrome. In our first appointment, he marvelled at the shape of my right foot, and at the way it turned red the moment I stood – going as far as to call a colleague in to see it change colour, like it was some party trick.
But he was lovely and helpful, and issued nerve blocks – a half-day procedure, where I went into hospital, was put under (anaesthetic), and jabbed in the back with a big, big needle, right in the nerve with anaesthetic. This was an attempt to ‘reset’ the nerve, to get it back into normal function. I had ten of these nerve blocks, over the space of about three months, although at a cosmetic level I never felt they helped.
The right foot continued to claw, the toes bending like spider’s legs. The jabs of pain gradually abated, but the sensory input was out of control. One time I stepped on a hot pepper seed – no bigger than a pin head – and felt as if I’d stepped on a six-inch nail and it had driven right through the sole of my foot. Other occasions – usually when I walked – it felt like my toes had folded under my foot, and I had to check to see for myself that wasn’t the case. Often, there were severe burning sensations that made me brace myself. Sometimes, it felt like the foot was in a totally different position than it was, and other times it felt like the fracture was rickety, like it was only pinned together with a rusty hinge.
Gradually, things settled, although not completely, and I regained strength and functionality – just not all of it. During one of my periodic visits with the surgeon, he admitted he never expected me to get as far as I had. He told me the textbook answer for nerve recovery was that whatever I was left with after 18–24 months is what I’d be left with for life, although in some cases, nerves spontaneously regenerated following that period. It wasn’t something to count on, though.
I asked him about the possibility of removing the plates at some point. He held his hands up, almost in surrender.
‘I’m not going near it,’ he told me.
He explained that surgery might set it off, or antagonise the Complex Regional Pain Syndrome – a real possibility given the way it had reacted to surgery when he’d inserted the plates. So that was it. He wouldn’t touch it again unnecessarily.
I also had to take a seminar to learn about management for Chronic Pain. Some aspect of the injury always hurt – usually the foot or toes (especially the big toe, which seemed the epicentre of the CRPS), sometimes the ankle, occasionally the shin or the calf. The training became an adjunct. I simply learned for the pain to be there.
This was my new normal.
This was life now.