Nursing a Navicular and Talar Head Fracture | GOOD MOXIE

Back in September, I had a misstep and fractured two bones in my foot/ankle; the navicular and talar head.

So far, my experience nursing a navicular and talar head fracture back to health has been humbling.

Being on the receiving end of the healthcare system for the last 9 weeks has been okay, but certainly not fun .  

Peg-legging around with my big boot, is a challenge.

But, my ankle/foot is healing.  

I have a renewed appreciation for what my patients feel like when dealing with a broken body part.

 Fracture of the Navicular and Talar Head 

Nursing a Navicular Fracture The N Spot

Though the other side “looked” worse,

this is where the pain was from the get-go.

 

Uncommon and Slow-Healing:

Navicular and Talar Head Fracture 

The talus is the base of the ankle.  The navicular is the bone that connects the ankle to the foot.

I realized early on that there isn’t a whole lot of information about the healing of these bones.  

Talar head fractures are an uncommon injury, while navicular fractures are notoriously slow to heal.  The navicular, along with the 5th metatarsal, doesn’t get the same blood flow as do other bones in the body. Thus, they are considered high-risk fractures. Because it’s not a common injury, there isn’t solid data out there regarding its best management.  The approach for my non-displaced fractures is conservative treatment. I’m okay with that.  In fact, unnecessary surgery is a no-no in my book.

But the “let’s wait-and-see” approach clashes with my “let’s fix-it” nature.

During one of my Ortho visits, I expressed my frustration with the pain, swelling and continued bruising of my ankle and foot.  You’d think that being a nurse I would have understood my situation. But, I really didn’t.  It took a couple of weeks to get a clear diagnosis.  Initially, I was trying to walk on it and keep my ankle moving. The pain was horrible, but I didn’t want to end up with a stiff, arthritic foot/ankle.  Even after an MRI showed the navicular and talar head issue, it took me a while to understand the nature of my injury.

Just because surgery was not required at the moment, that didn’t mean it wasn’t a possibility.

Because the navicular bone supports the junction of the ankle and foot, the bone has been described as a “keystone”. 

A keystone is that wedge-shaped stone placed at the apex of an arch. It’s the final piece placed during a building’s construction and it is literally the key that locks all the other stones in place and allows the arch to bear weight.   Damage to the navicular means losing normal mobility of the joint.  

Without the strength of the navicular bone, the arch collapses.

I was told that if the bones did not heal, I was in for a much longer recovery.

The importance of non-weight bearing while the navicular heals is because of the decreased blood flow to that bone.

Further stress on the healing bone could cause it to break completely or end up healing poorly. 

I have a new respect for the complexity and importance of that little N-Spot that joins the ankle and foot.

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You can’t rush Mother Nature.

But, here are things that can help with the healing process… 

Taking Care of the Body 

Initial Pain Management 

  •  R.I.C.E. rules:  Rest, Ice, Compression and Elevation.  This will help with the initial pain and swelling.
  • Heat Packs:  I stayed with RICE for at least a week, then switched to heat. Cold packs are great for swelling but warm packs are good to get the circulation going.  During the healing process, you can always alternate between the two. I found I had to revert to ice and elevation after working all day.  Warm baths with epsom salt/magnesium helped the aches too.
  • Pain Meds:  Ibuprofen, Motrin, Aleve/Tylenol/ Toradol, Aspirin, etc. – Be careful.  They are wonderful for relieving pain and swelling but use them in moderation. NSAIDs can interfere with bone growth/healing.  Toradol is an amazing pain med but it can also increase bruising just like aspirin. Tylenol is hard on the liver if you’re taking high doses for a long period of time. Also, keep in mind that Tylenol is a base for stronger pain meds. Make sure you’re not going over board.  Alternating an anti-inflammatory with a stronger Rx med works well for some people. I think that herbals work too. I used Helichrysum essential oil on the N-Spot of the inner ankle and over the top of the joint. It’s great for inflammation, migraines and it smells nice too!

Non-Weight Bearing Mobility 

  • Ditch the crutches:  Strict non-weight bearing means you’ll be needing a scooter or iWalk hands-free crutches.  For ease of mobility,  the iWalk 2.0 is a game changer for me. I move around slower than I would with a scooter but it has allowed me to be hands free.  I still work and do what I need to do around the house (albeit slower).  I think my body is doing better by walking instead of scooting with a scooter. My posture is better.  Just my two-cents.
  • Keep in mind that blood clots can happen when a leg isn’t moving much.  Know the signs and symptoms.

Eat and Sleep 

  • Good Nutrition: Focus on nourishing and anti-inflammatory foods. Calorie requirements go way up during the healing process.  I stopped my Keto eating style in favor of carbs/calories.  When I’m eating Keto-style I simply don’t eat enough calories to support a body in healing mode. I am careful to not go sugar crazy though. That’s not helpful when the goal is to minimize inflammation.  My ice-cream trips to the General Store are worth it though.  Bones need calcium, but calcium needs vitamin D! I am taking 5000units VitD 3x/week.  Check out the BetterBones website for great info on healing after a fracture.
  • Good Sleep/Rest: I sleep with a body pillow. This helps keep my ankle padded while I sleep without my boot.

Bone Stimulator 

  • Nerve/Muscle Stimulation: I am using a nerve stimulator unit that I have used in the past for neck pain/spasm. The use of a muscle stimulator won’t make the bone heal faster, but it helps with my pain.
  • Bone Stimulator:  Electrical and/or Ultrasound bone stimulators may be employed to enhance bone healing.

Taking Care of the Mind and Spirit

Managing frustration and spurts of “the funk” in dealing with this or any health issue is normal.
The only thing to do is find healthy ways to cope.
Things that I have found help keep my mind busy and relaxed….
Read or watch Netflix and fall asleep on the couch
Catch up on Thank-You notes
Work on this blog
Stay active with volunteer groups
Go to a movie
Go down an internet rabbit-hole and learn about something – anything
Don’t watch “the news”

 

Stay OFF of the Foot!  

Navicular and Talar fractures heal.

They just take time and patience. It was a challenge at first, but staying off of my foot has been the key to my healing.

On my way to work the other day, I was listening to an Oprah podcast with author Anne Lamott.

Her book and three simple prayers –  Help, Thanks, Wow – made so much sense to me.

“Help” is a word that I do not use often.

It took me 3 weeks to really stop moving after my injury and ask for help.
It is uncomfortable for me use the “H” word, so I know it’s space that I can grow in.
A very good friend gently pointed out to me that I do not share my struggles.
She didn’t really relate to me sometimes because I don’t share the ugly bits of my life.
Asking for help, however big or small “the ask”, is a really good sign that you are self-aware and secure.
Clearly, I am still working on this one.

 “Thanks” was easy

Sitting in the space of gratitude has helped me reframe my thinking in so many ways.
When I realize that I am feeling frustrated, I shift my focus to gratitude. I breathe and say “Thank you”. ‘Thankfully it wasn’t worse.  I love that I can use my arms and am thankful for the strength of my other leg.
Focusing on the “good” of any situation shifts my mind every time.

To speak “Wow” from my heart,  I must see things with my heart.

I have mornings that I still wake up with pain. But I sometimes notice, with my eyes still closed, that I feel a smile on my face.
I know it’s a new day. My ankle will heal. So, I slip my peg leg on and hobble to the kitchen for my morning coffee. In the time it takes me to get my brew going, I take a moment to look out the window. Rain or shine, I am in awe of the beauty of nature.
The Energy is everywhere.
~

It’s important to slow down, tend to and mend the body.

Broken bones will heal.

Healing with intention, from the inside-out, is slow,

but it is sure.

~

As long as you have wings – Fly!

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Flying through life

2018-11-14T00:02:16+00:00November 8th, 2018|Tags: , , , |0 Comments

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