My Ankle Replacement Journey

Background

I am a soon-to-be 81-year-old from Castleford West Yorkshire, I have been married for 51 years with one Son and two Grandchildren.  During my working life, I had many varied types of employment, Pattern Maker, Landscape Gardener, Salesman, and Miner and for 30 years I ran my own successful Landscape contracting Business, before retiring when I was nearly 68 years old.  

My business did private work but the bulk of it was commercial design landscaping and maintenance. One contract I had for the entire 30 years required the use of Strimming Machines on banks too steep to use machinery, this required my standing at difficult angles, putting significant strain on my ankles.

I have been very fortunate in that other than Osteoarthritis I have always been healthy.  I had three very successful surgeries for Osteoarthritis in my wrists allowing me to continue working.  By 2016  I began to have increasing pain in my ankles and difficulty walking, however this did not stop my wife and I travelling and making the most of our retirement, however by the time I received the surgery I was in severe pain.

Total Ankle Replacement Surgery No: 1 Left foot.

My journey has been a long and at times a difficult one.  In July 2019 I was admitted to the Elective Orthopaedic Suite (EOS) at Pontefract for Ankle Replacement Surgery.  From my first experiences in Out Patients C/0 Mr J Ayres, then later I had an exploratory Biopsy Surgery prior to my first Total Ankle replacement, to my recent stay on the unit, I received the most exceptional care from every level of staff: from Consultants, Nursing Staff, Outpatient Staff, Medical Secretaries, Porter Staff, Cleaners.

I was very apprehensive, I has not heard of anyone having this type of surgery before, I did some research prior to my surgery but, there was not really much to find and mostly from the USA, which has a totally different ethos to healthcare, compared to the UK.  

I had a General Anaesthetic and whilst in theatre was given a nerve block as part of my Total Left Ankle Replacement. surgery  I regained consciousness in the recovery room and was totally pain-free, I was returned to the ward with a ‘Back slab’ Plaster of Paris (POP) and heavily bandaged.  I didn’t sleep much that first night , I was waiting for pain to kick in as the nerve block wore off . . . . it never did! I had been given some oral pain medication in anticipation of possible pain.

The following day I returned home, I was told not to put any weight on my left foot so I used elbow crutches to get upstairs which was relatively easy, using one crutch and holding onto the banister, I was able to hop up the stairs my wife helping once I reached the top/bottom.  After a couple of days as I did not have any pain at all I discontinued the pain medication.

Because of my previous surgeries on my wrists I found using Crutches for any length of time difficult.  Whilst on our travels in the USA my wife and I had seen people using Knee Scooter/Trolly aids.  After some research we located a company in Halifax West Yorkshire who imported this type of ‘Aid’ we purchased one and was delighted, it allowed me to get out and about more.

After two weeks I returned to Orthopaedic Out Patients for removal of stitches the wound had healed well, the Back Slab POP was replaced with a full below knee POP for a further four weeks, still with no weight bearing on the left foot.  At my 12 week postoperative appointment I had the POP removed and was given a supportive Walking Boot and told I could gradually start weight bearing.  

I have driven ‘Automatic’ vehicles now for some years and therefore only need to use my right foot to drive ,so as soon as I could get into the car even with the POP on my left leg I was able to drive.  As soon as I was given permission to travel, we were off.

Total Ankle Replacement Surgery No: 2 Right foot.

At the time of my first surgery I had been told that my right ankle was nearly as bad and it would be only a matter of time before that too would require replacement.  It wasn’t long before I realised I was going to need this replaced too..

Once again I was referred to Mr J Ayres in and the ball was once again set in motion, I was put on the Waiting List for Right Total Ankle Replacement.  

The Pandemic was still impacting NHS waiting times as it was not possible for me to be given  a timeframe, I tried as best as I could to get on with my life, still travelling and making the best of things, “Walk a bit, sit a bit walk a bit more” .

After a significant period of time with no idea when to expect my surgery the pain in my right ankle had greatly lessened, I asked  myself  did I still need the surgery?  Following a consultation with Mr Ayres we agreed to defer surgery and for me to be reviewed again in 6 months.  Quite soon the pain returned and following updated scans, when I next saw Mr Ayres he told me very clearly “ Barry it’s knackered”. I was put back on the waiting list!

Once again it was a long and painful wait, eventually, I received a date for surgery April 2024, however, this was cancelled as one of the two Surgeons required to undertake this type of operation had an emergency which of course took priority.

After weekly calls to the Waiting List office, I eventually got another date.  On Tuesday, July 23^rd I was admitted to the Elective Orthopaedic Suite (EOS) at Pontefract for my second Ankle Replacement Surgery.  I was in a 4-bed bay on the ward with two other gentlemen, one of whom was also having an ankle replacement.  He was very very apprehensive and anxious, we got chatting, he had never spoken to, or heard of someone having this sort of surgery.  I explained I was having my second one, and spoke about my earlier experiences.  He was very grateful and reassured, even the following day saying it had been one of his more pleasant surgical experiences.  

I again had a general anaesthetic with nerve block.  I was pain free, the senior nurse reassured me that if I did get any pain there were medications I could be given including Rectal Suppositories! I had not come across this before, I settled down for the night and awoke with pain in my right foot, after about 20 minutes I rang the bell and asked for a ”Bum Tablet” !!!!!! The suppository worked quickly and I was able to settle and sleep.

I was discharged home the following day I had a back-slab POP I had been told that I had to be totally non weight bearing on my right leg and to keep my right leg elevated higher than my heart for 36 hours, I decided it would be easier to achieve this by staying upstairs.  It was much more difficult to get up the stairs this time as I didn’t feel safe on crutches but I was now 5 years older. I went up on my bottom, assisted top & bottom by my wife and using my Knee Scooter to get about the bedroom to use the toilet.

I took the pain medication for a couple of days before discontinuing them as  I had little or no pain.

After the 36hrs, I gradually started mobilising  coming downstairs on my bottom, keeping my right leg elevated when sat or resting.  One of the main difficulties was moving in bed the back-slab got fast on the  bedsheets, we tried putting my leg and POP into a pillowcase, but found the best solution and also later when I was wearing the Walking Boot was to cut the leg off a pair of tights and stretch it carefully over the POP/Boot.

Gradually I mobilised getting about with my knee Scooter, after two weeks I returned to Out-Patients OPD the back-slab was removed, the wound had healed well but, the back-slab had rubbed and made a sore, as this required regular dressing I was put into a Walking Boot rather than a full POP, but still non weight bearing for another 4 weeks.  Another issue this time was I was reliant on my wife to drive unlike before when I had been able to drive from quite an early stage.

My wife is a retired Nurse and was able to undertake the required dressings, gradually the sore is healed.  We were able to get out for short periods, visit Grandchildren, have occasional Pub Lunch, and into the garden.  

On Tuesday last exactly 13 weeks post-op, my wife and I spent the day in York, we walked a bit, had coffee, walked a bit had lunch, walked etc by the time we got home I had walked 4 KM with no problems.  We are looking forward to our next holiday in April 2025, unless we manage to sneak one in before then.

With best wishes and grateful thanks

Barry