Sleep Suggestions after ORIF (7 weeks post OP)

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I suffered a trimalleolar fracture on August 26 and underwent ORIF to repair it, (have a total of 13 screws and 2 plates) on Sept 6. Last week, one of my incisions developed a superficial infection and the doc removed the cast and booted me early to allow air flow to the wound. It has since began to heal as it should. However, at 7 weeks post op, sleeping has become increasingly uncomfortable. I lie awake at night nagged by pins and needles coming from my ankle and foot; I fall asleep and am woken by it maybe 30 minutes later and then have incredible difficulty getting back to sleep. I've probably gotten five hours of sleep in three nights. I have read this is normal but how do you tolerate it at night? Any suggestions would be greatly appreciated!

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  • Posted

    My ankle was fractured in 2 places and the tendon was stretched, I am 2 months post op,  I was getting pain at night right up to recently, the pins were taken out 3 weeks ago and it looks quite good but very swollen.  You can expect pain because it is healing, you had a lot of plates and screws by the sound of it, we just have to be patient, I can,t walk yet, can,t wait to be mobile again.

     

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    • Posted

      Ugh, I’m sorry about your tendon damage. I was incredibly fortunate to avoid and tendon or ligament damage however I’ll have all my hardware for the duration.

      I’m supposed to go to partial weight bearing next week and possibly be released to drive. My husband will be happy to release some of the chauffeur duties back to me! Just would love to get a decent nights sleep.

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  • Posted

    Hi Betsey .

     I feel your pain.i had a similar situation. I shattered my ankle - all 3 sides in January. I could not sleep for many many months. Was in crazy pain besides not being able to sleep-(likely due to nerve damage and ligament damage. It has been an unbelivably long frustrating process.)..people recover differently. Also when we can walk there is certainly a gratitude I never had before.

    One of the women from this forum told me she purchased a cold therapy machine and it was a godsend. I ordered it and it did not help me- but it may help you -I had to do straight ice bags all night. With a compression sock which I still need to wear.I strapped it down with an elastomer gel boot. I visited a pain doctor. And they put me on a pain patch on my back. I am an anti narcotic person but..I needed some help..plus I'm a serious exerciser- and exercise helps me manage my anxiety 

    its been about 9 months now- I was really improving but then developed an infection in my big toe from pool walking

    We removed the nail after 3 rounds of antibiotics didn't work... 

    i was doing really well and unfortunately a massue broke my metatarsal bones- have to be off my feel for 6 weeks. Checked myself for osteoporosis- luckily no signs. While I think all this sucks- we will get past this and be stronger. 

    I can not lie I do feel sorry for myself certain days- enough already!! but I keep running into this man my age in a wheel for life. I don't believe I have the strength to manage that. It's all a roll of the dice. Maybe some meditating... head space has 10 min meditations.. Maybe medicine for a short time for sleep even natural herbs such as melatonin or valerian root or anxiety( buspar)

    all the the best that this journey is as painless as possible

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  • Posted

    I have started waking up in pain as well.  I know this will be somewhat controversial but taking Ambien allows me to sleep through the night without being awakened by pain.  I had insomnia for many years before my fall so already had a prescription.  I had not taken it after my accident until about a week ago when I started waking up in pain. One must be careful about driving and using alcohol when taking Ambien but I don't think those of us are currently NWB have to about that.

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    • Posted

      I have some ambien, thought about taking it but it hasn’t been great in the past and made me feel terribly hungover the next morning. Also, it didn’t keep me asleep, just made me feel groggy. 
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    • Posted

      I am all for anything that helps! I have had difficulty sleeping before accident as well. But nothing like after accident- probably due to  pain lack of activity.

      I think we have to be careful  but we need sleep!

      Thanks for your input!

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  • Posted

    Hi Betsy! I am sorry about your lack of sleep. Maybe your doctor could prescribe something for the pain and something else to help you sleep. I am not much of a one for taking pills but sometimes it is necessary. I hope you manage to get some sleep sooner than later.
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  • Posted

    I have found that ever since my fall with fractures that I cannot stand compression...cuts off my circulation and causes more pain, tingling, numbness.  My boot also did the same thing.  I wear a sock now with the toes cut out and must loosen the boot in order to sleep.  When I alsolutely can't sleep, I take the boot off and keep my foot aligned on a soft flat pillow(I'm not allowed to twist the ankle at all).  I also soak my foot and ankle in a walkin tub in warm water.  Don't know if you're allowed to get yours wet.  Let me know if any of these things work for ya.

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    • Posted

      Compression bothers me as well. I started taking a xanax before bed and have had two decent night's sleep. However, last night I woke up to a throbbing foot. Took my boot off, unwrapped my ankle and carefully slept peacefully for the rest of the night. We retain water at night; I think that contributes to the discomfort. I'm going to try loosening my wrap and boot before bed tonight to see if that helps. 

      My doctor instructed me to begin trying to stretch my foot forward to loosen stiffened muscles. I believe flexibility will contribute to whether he says I can drive or not next week. Fingers and toes are crossed!  

      Yes, I am able to get it wet. The infection in my incision was what made them boot me early, they want it to get cleaned daily in the shower. No scrubbing, just light lathering and rinsing. The infection has thankfully entirely cleared in a week. 

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    • Posted

      I have a low fibula fracture, also in a boot (4 weeks in to my 6 weeks of NWB) and I find the same thing as you - I can't sleep with a tight boot at all. I either take it off entirely and prop on pillows or remove the tongue, let out all the air and do the straps back up. Luckily I am a pretty still back sleeper so I can stay put in that position. 

      I also do my flexibility exercises (foot up and down, side to side, big circles and alphabet writing) before bed and then slather the ankle with either Mobicosa (sea mussel gel) or arnica gel before popping it back into the sock (and then the boot if I am using it).

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    • Posted

      Had a followup ortho appt a few days ago (5 weeks into NWB with boot) and doc says I can leave the boot off at night, no problem.  He also says I can do the side to side range of motion, can start driving with the R foot in a week,  probably return to work (going house to house home health) in 3-4 weeks.  yay!
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    • Posted

      That is great news! It feels so good when we are allowed to progress to the next stage in our recovery process smile

      I'd love to be able to drive, but as it is my right foot that is impacted, I'm not expecting to get cleared to drive for some time yet (maybe early December?), but I too got good news today. I am allowed to start weight bearing as tolerated in my boot. I can go all the way to FWB - no limit! So far it is going really well. I was told to listen to my body and use pain as my judge of how much I can do. I think all the iWalking helped me as I am able to walk along using my wheeled walker quite comfortably (i.e. I'm not hunched over the thing so my foot is able to cope with a good % of my weight already). Icing it now and so far just a little swelling and no pain, so I'm really happy with today's "workout" smile

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    • Posted

      Yes!  You are coming along too!  It is my R foot that's affected as well.  All the other instructions you were given I was also given, but the weight bearing as tolerated, even to FWB starts for me on my 6 weeks post fall date..which is Friday Oct 27th, same day I was told I can start driving.  As far as that goes I'm leary of using the brake, but not the gas.  Saturday I am going to my 45th high school reunion.  I will be driving, but going with a friend.  I will use my knee scooter once I get there.

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