11 Oct Part 2: To do, or not to do surgery? That is the question…
As an osteopath, I am often asked “should I have the surgery or not? What would YOU do?” Normally my advice is this: look at all your options and make an informed decision. As someone who has thankfully never been under the knife, that is a very easy line to rattle off.
Now however the tables are turned….
While on holidays in New Zealand last week I had a nasty fall and injured my ankle quite significantly (please refer to my previous blog for the full story). While I was sitting on the couch with my very fat, very sore ankle trying to hold back tears all I was asked was, “what do you think you’ve done? Is it bad?” As a practitioner I was running through every possibility in my head and I think I was more anxious because I have medical knowledge, because in my gut I knew it was more than just a sprained ankle.
I am lucky that within 12 hours of returning to Melbourne I had an MRI with the report stating “significant syndesmosis”. There are two ways of managing this diagnosis: conservative or surgical.
I began my information gathering. In the space of 2 weeks I saw 2 surgeons, a sports physiotherapist, a sports medicine physician, consulted with my mum who is a GP, not to mention my esteemed colleagues and friends…. Everyone had slightly different advice!
Weight-bear as tolerated, don’t weight bare – allow it to rest longer, take anti inflammatories for pain and to bring the swelling down, don’t take anti inflammatories they slow the healing process, sleep in the moon boot, don’t sleep in the moon boot….
One surgeon advised conservative management – moon boot for 6 weeks, non weight bearing/driving for another 2 weeks and reassess in a month. The other said “well you’ve done a good job” and after examining and going through my MRI recommended that I have surgery within the week.
Now this is where it really got hard – which advice do I take? Is one surgeon being too conservative and is the other “knife happy”? What will be the quicker recovery time? How quickly can I return to work? When can I drive? How much is it going to cost? The Pros and Cons list was growing! Ultimately you know when something feels right or not. I decided to go with the advice that gave me the most confidence, and with the surgeon who I had more trust in to get the result I wanted.
I ended up having surgery 2 days after the consult with the second surgeon. I didn’t want to drag out the process any longer, and possibly lengthen my recovery time.
When the surgeon came to see me after surgery he said “It was more unstable than we thought, your fibula was moving all over the place, any more and we would have needed to put the screw in too and not just the tightrope”. Ultimately I had a high level grade 2 sprain. Luckily it wasn’t a grade 3 which would have required the bolt and a second surgery.
So my advice is, GO WITH YOUR GUT! Every body is an individual and has different wants and needs, and are in different circumstances. Unfortunately there is no cookie cutter answer, but ultimately do what feels right for YOU.
I am now 4 weeks post surgery and I’ve been working the last 2 weeks. I am back in the gym and I have 2 weeks left in the moon boot. I am almost pain free and I feel stable. I believe surgery was the right decision for me considering my current circumstances but again, there is no “one-size fits all” when it comes to these types of decisions. Information is power so arm yourself with the best!