8 weeks since sprained ankle and having real problems. (V v long post, sorry)

[moosemama]

Just finished typing this and it is very long, mainly because it's been so long and there's a bit of a back story. So, apologies and I hope there's someone out there who has the time and energy to wade through it all and hopefully offer me some advice ...

I posted on here a couple of weeks ago about my sprained ankle.

Basically, two months ago today I accidentally put my foot into a hole I hadn't seen and ended up with an inversion sprain. I was on holiday at the time, so spent two days with it raised and iced (the whole RICE thing). I then hobbled a bit for the rest of the holiday but I spent a lot of time with my foot raised in the back of our camper while dh took the dcs off somewhere.

I reckon it was at worst between a grade 1 and 2 sprain, it was swollen, but there was very little bruising and I put this down to having hypermobile ankles, so things naturally stretching a bit further than they do in most people without snapping or tearing.

The journey home, 10 days after the sprain, involved a 17 hour stint in our camper when I was unable to raise my foot. By the time I got home it was very swollen and extremely painful and I struggled to get my trainer off. Since then I haven't really been able to weight bear on it.

I was dragged off to A&E by my Mum two days after we got home, when she saw what a state I was in. The nurse I saw was convinced I'd fractured it after examining me and sent me for the standard three xrays, but the only fracture was one adjacent to the middle joint of my little toe, nothing where the worst pain and swelling was. At the time she said she was very surprised, as she'd have bet good money on it being fractured somewhere around the midfoot based on pain, swelling and the way I was walking. It was too late to do anything about the toe fracture, so she just sent me home with the usual sprain leaflet and advice to do some more RICE and standard ankle exercises.

I was quite upset because I was still in so much pain and couldn't weight bear, but accepted and followed her advice. Fortunately, my sister lent me some crutches not long afterwards and I followed some online tutorials on how to strap it up for support so that I could get around and do the school run etc. I carried on raising it whenever possible - although I have 3 dcs to chase around after and that means 3-4 school runs a day. Fortunately I only live across the road and down a small close from the school.

By 6 weeks after the accident the pain was getting worse and worse. The swelling around the ankle had all but gone and the little toe was much better, but the pain along the outside midfoot area and under the sole/arch was unbearable and I still couldn't bear weight. Despite the ankle swelling being almost gone, my foot itself was/is swollen over the top, right down to and including my toes and the whole foot regularly goes bluey purple and really cold and at other times red hot and really painful (feels like it's actually on fire sometimes).

On a particularly busy day I had to do 5 trips up and down to the school and by the time I finally got to the sofa to rest that evening I couldn't move my foot without screaming, so I booked a GP appointment.

GP basically said it's just a sprain and although she still hadn't received my xrays, she was happy that the hospital wouldn't have missed anything, as the xrays are double checked at the end of each A&E shift. I pointed out that I had a 5th met avulsion two years ago that the same hospital missed both while I was in A&E and on the subsequent check. That time I walked on it for a fortnight before being sent to a different hospital by another GP. So obviously I have very little faith in the first hospital. She insisted all I needed was mega strength co-codamol and naproxen, which I told her I couldn't take as I was just getting over gastritis caused by high-strength ibuprofen that I'd taken for the sprain.

Dr wasn't pleased that I was pushing for something to be done and very grumpily asked "Well what do you want me to do about it?' I said, I couldn't carry on as things were and just wanted it looked at by someone who might have some idea what the problem could be. She said that she wouldn't/couldn't send me for more xrays, but after I repeated tearfully that I genuinely couldn't carry on like I was she said she would put in a request and it would be up to the hospital if they xrayed again. She also said my alternative would be to go to A&E at the other hospital on the basis that it's got worse, but that they probably wouldn't like it if I did that and protocol was for her to send me for xrays.

I waited for the hospital to contact me rather than bothering A&E, but in the meantime, every night after being on my feet in the day my foot swells up from the toes to the calf, goes bright red and hurts like hell. I've also developed a lump in the middle of the front of my ankle joint, that has a bruise around it and developed tiny pinprick type dark red dots in random places all over the top of my foot and ankle - oh and as of yesterday there seems to be a darkish bruise appearing at the base of my big toe. Also, all my toes regularly go black/purple when the swelling and redness flares up and when that happens they really hurt. All very odd considering there was no bruising at all with the original sprain.

I went for my second lot of xrays last Saturday and the radiologists were lovely. They only took two images, repeating two of the angles taken last time, but spent ages looking at them and couldn't find any sign of a fracture. They did say that some sprains can take a long time to heal, but as the initial sprain-type swelling has gone and there's still significant swelling over the forefoot, as well as other 'unusual symptoms' she is going to mark my results as 'for further orthopedic investigation', as she feels I should have been referred to an orthopedic foot specialist in the first place, rather than sent back to them for repeat xrays.

I was told it would take a week for my results to get back to the GP, but when I called to book a follow up appointment they said they can't fit me in for two weeks and that it wouldn't matter anyway, because xrays usually take about two weeks to reach them.

It's now 8 weeks post injury and I am really struggling. Having worked out that my foot only swells etc if I bear weight on it, my Mum, bless her, has been doing the school run for me so I could spend as much time resting it as possible. I kept the weight off it from last Saturday lunchtime, just after the xrays, until Thursday afternoon and it did seem a lot better, but then I had to do a school run and by Thursday night it was swollen and painful again and afterwards I had more red pinprick bruising.

I am at my wits end. Mum is off on holiday for 10 days as of next week and that means I will have to go back to 3 to 4 school runs a day, yet there is no sign of me even getting it looked at again yet.

Obviously I will go back to the GP as soon as I can get an appointment, but then it could be weeks from them referring me to me actually getting to see an orthopedic consultant.

I have put a photo on my profile of what my foot looked like on Thursday night when it had just started to swell. It actually got worse after dh took the picture, but I was in no mood for having any more photos taken.

Apologies and a gold medal for anyone who has made it this far through my post. Any suggestions or advice would be really appreciated as I really don't know what else to do and am in constant pain, but nothing is being done about it and it doesn't seem like anything will be done for weeks yet.

[crashdoll]

I'd push for a referral asap. I tore a ligament and it was far more painful than when I'd previously broken my foot. When I tore the ligament, it was completely dark blue and purple all over and double the size - I shit you not - it looked awful! I thought I was being silly about my sprain and battled on. Months later, I saw a foot ortho who said it should have been surgically repaired but it was too late and I've been left with long term issues. In my completely unprofessional opinion, it sounds like you've torn something and having been in a similar position, I would urge you to be forceful with your GP. If you're near London, I can recommend a fab consultant.

[moosemama]

Thank you crashdoll.

Just realised I didn't upload the photo - doh!

Have done it now.

I haven't had extensive or dark bruising at all, which is what makes it all the more strange. I have a black bruise coming out around the base of my big toe at the moment, but that's new and came out after one of the bad evening swelling episodes, when my toes went black and my big toe in particular really hurt.

From what I've googled I reckon it could be a combination of ligament/tendon damage and either scar tissue or synovitis. My other concern is/was a mild/non-displaced lisfranc, but I think it would be even worse than this if that were the case.

I don't live anywhere near London unfortunately.

I was going to try and get to see a different GP at the practice, but it seems I'm going to have to take whoever has a cancellation if I want to be seen within the next fortnight. I have to call them at 8.30 am every day next week to try and get in.

I can't believe I am still in this state and haven't even been referred for a specialist to look at it yet.

[SeveredEdMcDunnough]

Gosh that looks terrible. I was wincing throughout your post, it sounds dreadful. They can't leave you like this.

I remember your other thread as well. I'm so sorry this is still going on.

My only other suggestion (apart from what you're already doing - the ringing up every morning) is to possibly look at going private. I hate the idea of it and it will be £££ but if it's going to be weeks of pain then it might be your best option.

I don't know. I just hope that you can be seen soon before this leads to permanent damage.

much sympathy x

[PenisColada]

Have you googled complex regional pain syndrome ( sorry on iPad so can't link)

[ValiumQueen]

I remember your other thread as I had broken my ankle. I broke mine 12 weeks ago, and after walking on it, had it Xrayed and treated appropriately. I still cannot walk without pain in anything other than my crocs, and cannot tolerate socks still. I am sure being about to have a baby is not helping though.

There is clearly something wrong, and you have been extremely patient. Not impressed by your GP. Unfortunately sometimes in the NHS you need to get loud to be seen. How about going to A&E this morning and refusing to be seen until you get someone from Orthopaedics to see you, or at least an appointment at fracture clinic this week to be reviewed? Even if you just get a boot to wear, it will be something, and prevent further damage.

Time to get bolshy me thinks!

[moosemama]

SeveredEd, I have looked into going private, as my Mum knows a really good Orthopedic Consultant locally, but all I could afford was an initial consultation and no tests. I did actually book an appointment, but then cancelled, as all he could do was a cursory assessment, speculate about what the problem is and then send a letter to my GP suggesting a referral to NHS orthopedics and what tests would be prudent. So, the outcome and timeframe would be the same as going straight to the GP for a referral.

PC, I have considered CRPS/RSD and thought it might be that for a while, but via trial and error I'm pretty sure it's the weightbearing that's making it's worse now. I'm also confused by the random bruising and red pin-prick marks that keep coming up and afaik that doesn't tie in with CRPS symptoms.

To be honest I have googled a lot (not much else to do when sat with your foot in the air all the time) and considered so many different options, but it doesn't seem to neatly fit any one of them. The Radiologist said she felt I needed a MRI or CT scan to get to grips with what's going on internally, as anything else is just speculation. I've given up trying to work out what it is myself now, I just want someone who knows what they're doing to sort it out.

Valium, I remember you from my first thread (this is number 3 ). Sorry to hear you are still in so much pain with your ankle, I hope it improves before your baby arrives.

I have had to stick with wearing crocs as well, but have now had to buy a size up as it became painful, particularly over the top of my foot and inside of my ankle, to wear my old ones. I was also strapping it up when I had to go out and using a support bandage at home, but if I do that and then move around too much the swelling increases and I have to take the bandage/support off because it gets too tight. The support bandage was actually a bit too loose when I bought it a couple of weeks ago, now it's too tight to be comfortable.

You're right, I do need to get bolshy, I'm just not very good at it. The GP was so rude and dismissive last time. She wasn't even one of our normal GPs, just one of the ones we get on 6 month training rotation. I was really upset by her level of arrogance, especially as she didn't even bother to properly examine me, just poked three different spots on my foot and asked to look at the sole (presumably looking for lisfranc bruising, which obviously would have dissipated after 6 weeks anyway). How she could know it was 'just a sprain' with no specialist knowledge and without a proper examination or further tests is beyond me.

I really don't want to go to A&E, as it's neither an accident or an emergency and it doesn't look as bad as the photo at the moment, having been non-weightbearing since Friday evening. It's still swollen and a completely different colour and shape from the other foot, but I don't think they'll take it seriously unless I go when it flares up really badly.

Dh says if it does that again we will just have to go straight to A&E there and then, even if it means calling Mum to babysit late at night.

Thank you all for replying, it helps to get other people's thoughts and ideas.

I think the bottom line is that there is nothing I can do, other than keep phoning the GP for a cancellation and hope for a quick referral.

[orangeflutie]

Apologies if you've already said this in your post but given your GP and the surgery have all your medical notes, would a GP not speak to you on the phone?
I can do this at my doctor's surgery if I can't get an appointment.

There is then the possibility he/she could refer you to a podiatrist/orthapaedics after the phonecall rather than keep you waiting.

I appreciate that it's often difficult to get past the receptionists though!

[moosemama]

I wondered that myself orangeflutie, but when I needed to speak to someone about my ds I had to book an appointment slot for a phonecall, so am thinking it's probably no better an option.

According to the receptionist, they won't have my xray results or feedback from radiology for another week either so I think they'll be unlikely to refer without actually examining my foot themselves.

The receptionist is lovely, but the surgery rules are pretty strict. They do have a triage system and I wondered if they might see me via that if I am really insistent about how much pain I'm in. Have a feeling they might refuse to though, based on the fact that my results won't be in.

[crashdoll]

Oh moose, I looked at the photo and it looks bad. So painful. I really hope you can get this sorted asap. Are you taking any painkillers or anti-inflammatories?

[Viperidae]

I don't know if this helps but I fell and sprained both ankles simultaneously 2 years ago. I flew to Spain the next day and by my return 5 days later had the whole swelling to the knee, agonising pain thing too.

GP sent me to A&E who said soft tissue injury, GP said not good enough as they hadn't x-rayed so sent me back, x-rays showed nothing so they sent me home only to ring me to come back for tests for DVTs. These were inconclusive so I was given anticoagulants to inject into my stomach over the weekend. More tests on Monday gave all clear.

I was unable to wear anything but my fitflops and had swelling and pain for at least 3 months. GP told me to expect about 3 months before real improvement. One ankle still swells now and again even 2 years later.

Hope yours gets better soon.

[moosemama]

Doctor gave me high strength co-codamol, but I can't take them, as I just fall asleep or zone out if I do. She also gave me Naproxen anti-inflammatories with Omeprazole to compensate, but having just had gastritis last month (caused by the high strength Ibuprofen I took for my foot/ankle) I am very wary of taking them.

Viperidae that sounds awful. Injections into the stomach! Didn't they do any CT or MRI scans to rule out tendon or ligament damage? I would have thought that was the obvious thing to do if nothing showed up on the xrays.

I had a bad sprain and 5th metatarsal fracture on the other foot two years ago and that was misdiagnosed by the same A&E I went to this time. I walked on that for 10 days before being sent to the main city A&E and they spotted the fracture straight away, plus took loads more xrays to confirm it. I was in an aircast walking boot for 10 weeks that time. I still get some pain and swelling over that old fracture site as well, but I was told these things rarely heal 100% as you get older.

How on earth did you cope with both ankles being injured? It must have been hell.