PAIN INFO

My story starts on the 6th of July 2008, just over 7 years ago. I went to a house where my daughter was staying and upon leaving I missed the stairs in the dark. I inverted my right ankle and heard a loud crack. I attempted to stay upright and stepped on my left foot and then back onto my right foot at which time I realised I was in extreme pain and that my ankle lacked any support at all. I allowed myself to fall the last two steps and lay face down in the driveway until an ambulance arrived. I was taken to Wollongong hospital, x-rayed, told it was a sprain, that I should walk on it, and sent home without pain killers despite being unable to walk from the hospital even with crutches. They wheeled me to my husband's car in a wheelchair.

When I arrived home I was unable to even sit up, the pain was so bad. I was unable to walk to the bathroom without using a wheeled computer chair and my husbands help. For two weeks he came home from work at lunchtime every day to take me to the bathroom. I realised there was something seriously wrong with the ankle as I have had sprained ankles before and this was not healing. I went to see my doctor who immediately sent me to a physiotherapy to be fitted for a walking boot. She also gave me panadiene forte and 5mg norspan patches (I am allergic to fentanyl) and recommended I have an MRI and see an orthopaedic Surgeon.

The MRI showed 11 seperate injuries including the end of the bone was crushed and there were four bone marrow bruises. The Orthapedic surgeon told me that basically bone bruises take around six months to heal and that all we could do was physiotherapy, pain management, and slowly start using it, although as it had been a month, I had already been trying to walk on it when it should have been not walked on at all.

Six months later I was still in excruciating pain, especially on weight bearing. I was using 20mg norspan patches, and between 6-8 panadiene forte and still crying in pain everyday. The pain never stopped. It was always there from the moment I woke up, and worsened thought the day. My day was to shower on a shower chair, move to the couch and stay there all day, only getting up to use the bathroom. My husband would make my lunch and a snack and give me a large bottle of water before he went to work so I didn't have to stand much. I did my physio religiously but my ankle moved less and less and felt very unstable. The surgeon recommended we try cortisone injection which gave me no relief.

By 12 months I was extremely depressed. My life was constant pain, broken sleep, the couch and TV. I couldn't go anywhere, or do anything. Friends stopped coming to see me. I became isolated and cried all the time. I couldn't see a future for myself and made a plan on how I would kill myself as I didn't want to do it at home as my son would be the one who came home first and I didn't want him finding me. I told my husband and he took me to my doctor and I and was given anti-depressants and sent to a psychologist.

16 months the surgeon suggested he perform an arthroscopy to see why there was still so much pain. The surgeon removed a large amount of scar tissue and decided to put in a screw to stabilise the bones. I was not allowed to walk at all for 8 weeks. Then I had another operation to have the screw removed. There was improvement for six months and then a decline. I was still never without the pain. We reduced the norspan and eventually stopped it as I felt it contributed to the depression. I still used between 6-8 panadeine forte a day. We tried physio, remedial massage, and osteopathy. I couldn't get any relief.

Two and a half years post fall I had a second arthroscope done and the surgeon removed a large amount of scar tissue and debrided the bone back to give me more room. There was no improvement after that surgery and we decided not to try further surgery. The doctors believe the reason for my pain is the cartilage was destroyed during the original fall and scar tissue keeps filling up the ankle joint.

I was sent to St Vincent's pain clinic two years ago and thier advice was to go back on norspan and to stay off the ankle as much as possible. They suggested the walking boot and crutches to be used at all times when I must walk. I find this impossible to use around the house so I only use the crutches and walking boot in public.

The pain has continued to get worse. The beginning if this year it became intolerable again and I didn't want to increase the amount of norspan.

In April I saw a different pain specialist in Wollongong. I was sent to Lawrence Hargraves hospital where I spent ten days on a ketamine drip so I could be taken off the norspan and panadiene and start again with palexia. I have responded well to the palexia. Now there is only pain when I use the ankle. I can tolerate standing or walking for around 10 minutes before the pain makes me sweat, 15 minutes before I feel neaseaus and around 20 minutes I am going to throw up from pain. The ankle also swells as soo as I use it or if I keep it down, such as sitting down. I have been fitted for a patella tendon bearing orthosis and I am waiting for it to be made. It will mean I will be able to stand without putting any weight through my ankle. The ankle will still swell so I will still need to rest it. I am still isolated, still unable to do things other people do, like drive, use public transport, do housework, have a job, go out in public without the use of a power shopper or wheelchair. I cannot think about the future. I have been in pain for 7 years and I cannot think that I will be in pain for another 7 years. I cannot think that my life will still be spent sitting on the couch with my foot raised for the next 7 years without being reduced to tears. All I can do is get through today. And then tomorrow. That is how I live.

I can talk more about how my life has been affected. During the first year I gained 20 kilos in weight. The past two years I have lost 40 kilos which has not relieved the pain but is better for my health. People have told me that I would be better if I lost weight, that they don't know how I live like this, that they couldn't do it. I was treated with an amount of disdain by a doctor until she saw the new MRI results which showed a deterioration in the ankle joint, at which time she sent me to the pain clinic

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