On Friday November 1, in Monterey, CA, I fell and broke my ankle.
How it happened
A typical city bus in Monterey.
I don’t know why it happened, but I stepped off a bus and somehow tripped on the steps. When I fell, my foot must have twisted under me. I waved the bus on, because I thought I just needed a minute to catch my breath and I would get up. But I could not get up at all and my ankle swelled to the size of a tangerine! Luckily, I was right in front of a motel, and the front desk worker came outside. I asked him to help me get up and he brought me into the office and called a cab for me, so I could go to the emergency room.
After they x-rayed it, the doctor told me I had a small fracture in my outer ankle bone (lateral malleolus). I would need to stay completely off my foot for 6-8 weeks! They put a Velcro splint on it, gave me a pair of crutches, pain meds, and an instruction sheet about after-care. I told the doctor I was only going to be in Monterey for 1 more week of my 4-week stay, and that after that I was headed to San Francisco for a week, then to Boston on Nov. 12. He told me to be very careful on the hills of San Francisco. When I told him there might be snow in Boston, he just shook his head.
I took a taxi home and the driver helped me get into the house. Luckily the Airbnb cottage where I was staying was on one floor, ground level, but there was a front porch with about six steps. I had never used crutches before and didn’t know how to get up steps with them. I tried hopping on one foot up the first step and that jarred my whole body so hard that it shot pain through my injured foot. So I ended up sitting down and scooting up backwards. I had to crawl through the entryway and do the same thing up one more step into the kitchen. From there I could manage to a chair in the living room, with the taxi driver’s help.
Getting up these steps was hard when I first arrived home from the ER!
Getting help from friends
While I was waiting in the emergency room I texted two of my best friends right away to let them know what happened. I’m so happy we live in a connected world! I was staying in Monterey by myself, but I never really felt alone. I also contacted the owner of the Airbnb cottage where I was staying to let her know what happened. She offered to get me groceries or bring me anything I would need. Nice! Luckily I had enough food for the next few days. And my friend David had already planned to drive down from San Francisco to join me for the last two days there and drive me back up to his place (where I stay when I’m in San Francisco). So he decided to come to Monterey a day earlier to help me out.
So for Saturday and Sunday I was alone. David came on Monday. I practiced with the crutches, but wow… you can’t carry anything! I had never thought about that. Also, my upper body strength doesn’t quite match my lower body weight, so it was very difficult. Eventually I realized that it would be easier to rest my left knee on a kitchen chair and drag the chair around in front of me from room to room. That way I could bring my water bottle to the bedroom, or food from the fridge to the counter to prepare it.
Re-learning everyday movements
I now have more empathy for anyone who has a mobility problem! I had to re-learn every little movement. Getting dressed, getting up from a chair – every little thing is hard when you can’t put any weight on one foot. I’m pretty good at balancing on one foot, but there is a limit to how long I can stand that way! My right hip got tired fast. Also my shoulder muscles began to hurt after the second day of lifting the wood chair with my knee on it. And my calf got sore and bruised from constant weight on it as I moved around. I tried towels, pillows, blankets, everything to make a soft surface on the chair seat… but it all felt hard as a rock after a while.
For that last week in Monterey, I spent most of my time in bed with my foot elevated on pillows, my laptop in my lap, watching movies & TV on Netflix. It hurt a lot the first two days, but much less after that. I never took the pain meds because I don’t like taking any drugs unless I absolutely have to. The pain wasn’t as bad as the migraines I get from time to time, so it wasn’t a big deal, just annoying.
I also continued working on my book project (Best Apps for Academics), for about two hours per day. I had some deadlines with my copy editor that I wanted to meet and it felt good to be working part of each day.
I was so happy when David came, because now someone could help me out with things around the house! It’s a pain when you hobble all the way from the kitchen to the bed, only to realize you forgot something and have to go back again.
Monterey has a wonderful bike path near the ocean.
My rental bike.
I was very happy that I did so many fun things in Monterey before it happened (long bike rides by the ocean, lots of walks), so I didn’t feel too bad about missing out on fun during that last week. David went bike riding and walking by himself. And he used the free aquarium pass that came with the cottage. I didn’t mind, since I’ve been there before.
It’s harder to deal with being injured when you’re changing locations
When you’re recovering at home, you can get used to doing things in a certain way, based on how your house is arranged, and you can eventually find solutions to your mobility problems.
When you’re moving from place to place like I am, it takes more planning! Each place is different, with different challenges.
Normally I would stay in one place for a few months at a time, but at this time of year I had plans for more frequent movement.
Here’s the schedule I had planned:
Nov. 7 – Leave Monterey, go back to San Francisco, stay at David’s house in Bernal Heights (small house on a very steep hill).
Nov. 10-12 - Stay with friends in Oakland in a beautiful craftsman-style house with a guest room on the second floor (long staircase, beautiful hardwood floors that I was afraid to scratch by dragging a chair around).
Nov. 12 – 21 – Stay in Boston where I house-sat for friends earlier this year and now one of my best friends was doing the same. The house is a beautiful 3-story with very long staircases between the 3 floors. Bathrooms only on floors 2 and 3. Shower only on floor 3.
Nov. 21 – Dec. 23 – Stay with friends in Montpelier, VT, in the first floor guest room of a 3-story house with 2 baths and 2 kitchens. Luckily one of the baths and one of the kitchens are also on the first floor, so it would be possible to do everything without going upstairs.
The first thing I did was cancel my visit for 2 days in Oakland. I was worried about everything I would need to do to set myself up there and also worried about scratching the beautiful floors at their place! My friends were totally willing to make a bed for me on the ground floor, so I wouldn’t have to try the stairs, but it was just too much to adjust to for only 2 days.
David constructs a knee platform for me on his mom’s unused walker.
I was all set up in Bernal Heights with a makeshift knee carrier that David assembled by adding wood planks at knee level to his mom’s unused walker. This was for resting my knee, and was easier and lighter than dragging a chair around. It wouldn’t fit into the bathroom though, (too wide for the narrow door), so I switched to a smaller chair that I could lean on in the bathroom. I slept on a futon on the living room floor, because the guest bedroom was down some narrow stairs that would be too hard to navigate. Once I was set up there, I could do things on my own, and I realized it would be difficult to set that up in a new place for only 2 days, even if there was more room there.
All my friends were super helpful, understanding, and flexible. I paid more to keep the rental car longer (David and I were sharing, since he is also car-free), and he drove me to the airport during morning rush hour, since it wouldn’t be easy for me to take public transportation. My Oakland friends and I still got together and we had a great time catching up and discussing my time in Oaxaca.
I used one of the regular crutches with my hands-free crutch before I bought a cane.
Of course all my Facebook friends were sympathetic with lots of comments and tips. One idea was that I could get a knee scooter to drag my leg around on. I didn’t even know these existed!
So I started researching alternatives to crutches and found some interesting “hands-free crutches.” These allow you to walk up and down stairs more easily than regular crutches and make it easy to carry things. I decided to wait to get a knee scooter until after I arrived in Boston, so I wouldn’t have to check another item on the flight.
Also, my main worry was dealing with stairs, and a knee scooter is only good for moving around on the same level.
After reading various reviews, I decide to order a “hands-free crutch” as a rental for $100/month. It arrived in Monterey and David put it together for me. I was so happy to have a way to get down the porch steps and into the car! It was the first time I left the house in almost a week. You have to take it off when you sit down, so I used it to make my way to the car, then took it off and it went into the back seat.
We stopped at an Apple Store on the way to San Francisco. The Burlingame store allowed us to park very close to the front door, all on one level. (I got advice about which Apple Store between Monterey and San Francisco was closest to parking by asking the question on Yelp). I practiced with the crutch by walking from the car to the door. I wanted to see the new iPad Air, and if you know me, that’s a motivator! It was slow going, because the hands-free crutch was heavy and the straps were difficult to buckle and remove (requiring two hands). But at least it was easier than regular crutches. Having a platform to lean your knee on is great. It makes you feel almost like you are walking normally. And you can carry things! I used one of the regular crutches in one hand to stabilize myself, and later I ordered a cane from Amazon that works well for that purpose.
A better hands-free crutch: Flexleg
Practicing on Kristin’s porch
Going down steps
Made it down the steps
During my research I had seen another type of hands-free crutch I liked called Flexleg. But when I tried to order it, their website kept giving errors, not allowing me to complete the transaction. So that’s why I found the other model and vendor.
I really liked the look of the Flexleg though, because it has Velcro straps – easy to remove with one hand. And it looked lighter. My current hands-free crutch was a pain to put on and remove because you needed to use two hands to attach and detach the buckles. So I called Flexleg and placed an order by phone. They gave me a discount on overnight shipping because of the problems with their website. I wanted to get it before the trial period for the first crutch ended, so I could compare and see which I liked better.
It came on a Saturday while I was in San Francisco and again David assembled it for me. It took quite a bit of adjusting to get the knee platform height right for me, but finally we got it to work. I practiced with it on Saturday when we went to a movie and on Sunday when we met my friend Kristin in Oakland. I was able to practice stairs on her front porch and also test how I would use it in handicapped restrooms by trying it out in the coffee shop where we hung out. It was easier than I expected and a lot better than the first crutch. Yay! Stairs were no longer a barrier. This was important to me because I knew that where I would be staying in Boston had giant staircases with 18 steps each (3 floors).
David helped me return the first hands-free crutch. I got a refund, since it was a free trial. I also packed up a box of stuff to mail to Boston, to make my bags lighter. I needed to include the large walking boot that they gave me at the emergency room, which is meant to be used later on when I can start to put weight on my foot. I also needed to keep the original box that the Flexleg came in, so I could return it when the rental is over.
Flying with a broken ankle
Curbside checkin with my Flexleg at SFO
Luckily my Virgin America flight from San Francisco to Boston was direct. I called them to ask about my options and they reserved a wheelchair for me in the airport on both ends. I had a window seat reserved and I decided not to pay extra to change seats, but take my chances when I got to the airport. That worked out well, because the gate agent moved me to one of the best possible seats – the bulkhead row. It’s the first row of economy (they normally charge more for this row), behind a wall that separates the first-class area, and there was enough room to stretch my leg out a bit. The person in the window-seat could even get out without me needing to stand up. Lots of room. And no extra charge.
It was also a breeze going through security because they wheeled me through the back hallways to a different (and very quiet) security checkpoint for employees. I had to have the pat-down, since I couldn’t stand up with no help in the x-ray scanner. It wasn’t bad.
I was a bit worried about the swelling in my foot, since feet can swell even more during flights (and I had read scary stuff online about people getting blood clots – don’t read scary stuff online about your health!) It did swell, but not that much more and I brought a large, empty zip-lock bag and asked the flight attendant for ice to help the swelling at one point. I was somewhat restless, trying to find a comfortable position, but was able to distract myself by watching Downton Abbey on my Macbook Air. (I love that Virgin America has outlets at every seat!) I was a little worried about using the tiny restroom with my Flexleg, but I managed to make it work, and they let me use the one in first class, since it was closer. It was all easier than I expected. The 6-hour flight went quickly.
Navigating large staircases in Boston
These stairs scared me at first. Now I’m a pro.
When I arrived in Boston, my friend/housemate Melissa met me at the baggage claim to help with my suitcase and carry-on bag. An attendant brought me from the arrival gate in a wheelchair. My friend Jeremy drove us home. I’m so lucky to have so many great friends! Melissa made dinner for us and I told them tales of Oaxaca and Mexico City.
I managed to navigate the very large staircases with my Flexleg. Watching online videos about how to use it helped. You use your good foot first going up, and the injured leg (on the platform) first going down (you go down backwards). What made it easier is that there was a large, sturdy railing to hold on to. I used the cane to help.
Knee scooter – good for getting around on one floor.
So it’s now I’m living in a nice room on the second floor, same floor as a bathroom. I need to make a trek to the 3rd floor for showering and I’ve gotten used to that as well. I use a small plastic bench in the shower to rest my knee on. I can remove the splint (so I don’t have to worry about a cast to keep dry). The rented knee scooter arrived and I use it to easily move around on the second floor. It’s handy for quick trips from bedroom to bathroom and also for leaning on while getting dressed. It saves me from having to attach the Flexleg every time I want to move around. And the soft, rubber wheels don’t mark the floor at all (better than dragging a chair around, like I did in Monterey, with felt tips that tend to fall off).
At mealtimes I make the trek down the stairs to use the kitchen. Having a hands-free crutch makes it easy to prepare meals. Luckily the kitchen is small and most things are in easy reach.
Getting around in Boston and Cambridge
On Nov. 14 I had my first visit to my primary care doctor. My friend and housemate doesn’t have a car, and my other Boston friends who have cars all work during the day. Also, this house has no driveway or parking spots (since the owners, my friends, are also car-free, they rent out their two parking spots).
So I called a taxi, which usually is not a problem, but for some reason all the taxis were busy and it took about an hour and calling more than one company to get one to finally come! I called the doctor to explain and they were able to fit me in even though I was an hour late.
He did a basic checkup, sent me for x-rays, and then told me to contact the orthopedic doctor for an appointment. So I didn’t really learn anything about how my foot was doing (disappointing, since it had been two weeks and I really wanted some reassurance and advice about the healing process). I didn’t really know if it was normal to have so much swelling and bruising – (my foot was HUGE for the first two weeks), so relied on internet searches to answer my questions. My doctor was in a hurry (I even had a list of questions prepared) and didn’t have good bedside manner, he just focused on updating his records about me online.
Getting medical questions answered when away from your home state
One thing that was helpful was that my insurance (Blue Cross) has a 24-hour nurse care line. When I called them about my out-of-state emergency room visit, they told me about it. So while in Monterey I called and spoke to a nurse, which was reassuring. She told me to elevate it and ice it more. I’m glad about that service because when I called the office of the doctor who had seen me in emergency, I kept missing him and had to leave a message. The message back was to come back in to emergency (which would cost me another $100 copay, probably just to learn that I needed to elevate and ice it more!)
Apps that helped me: Hailo and Task Rabbit
Hailo iPhone app shows you where the nearest taxis are in real time.
Getting back to my doctor visit in Boston… I had the same problem getting a cab home when I was done with my appointment. Several cab companies said it would be at least an hour (all cabs were busy). I finally remembered that I have an iPhone app called Hailo. I had previously signed up for it and connected my credit card.
The great thing about it is that is shows you in real time on a map where the closest cabs are. When you request one, the driver gets notified and they can accept or not. Once they accept, you get a message on your phone with the driver’s cell phone number, so you can talk to them directly. So I used it and got a cab in 5 minutes!
I asked the driver some questions about it on the way home. He likes it from the driver’s point of view. The payment and the tip happen through the app, and they pay him, so no money changes hands. He also told me about a special promotion they were having, so I looked it up and got a $15 coupon to use on my next ride. Nice! Hailo is available for Android and iPhone, and is in 16 cities: Boston, Chicago, Washington DC, New York, Atlanta, Toronto, Montréal, London, Dublin, Cork, Limerick, Galway, Barcelona, Madrid, Tokyo, and Osaka.
For my visit to the orthopedic doctor a few days later I decided I didn’t want to deal with long waits for a cab. So I used TaskRabbit to request someone to pick me up, wait with me at the hospital, and drive me home. If you’re not familiar with TaskRabbit, it’s a great way to hire local people for odd jobs. I’ve used it in the past for help with moving and bringing items to the thrift shop. This worked out really well. I got a nice young man who helped me get down the front steps, navigated my wheelchair inside the hospital and was fun to chat with while waiting.
It cost me about $50, plus $5 for his parking. That’s about the same as round trip cab fare from where I’m living in Boston’s South End to Mt. Auburn Hospital in Cambridge. But it was a much nicer experience!
Good news from the orthopedic doctor
My walking boot, with inflatable air pockets.
Finally on Nov. 18 I got to see a doctor who could answer my questions and tell me how it was doing. He said that the fracture was stable and low down in my outer ankle. So that meant that I could start to put a bit of weight on it. He told me to begin using the walking boot with crutches. And to stretch a bit to get my foot to go back to a 90 degree angle (it was very stiff and hard to put it down flat). Then in two weeks, come back for more x-rays, and after that start physical therapy for six weeks.
Getting around with crutches and walking boot (before it snowed).
Difficult, but not impossible to be location-flexible with an injury
The main thing that’s been hard about all this (beside dealing with the injury itself), is moving to different people’s houses, each with different challenges.
I’m especially glad this didn’t happen earlier when I was in Mexico, Omaha, San Francisco, or the first 3 weeks of my time in Monterey (where I spoke at a conference).
Instead, it happened at a time when I already had plans to visit and stay with several of my very best friends, so I was able to get lots of help! I had to get over my own worry about being a burden on them… of course they were and are super-gracious about everything. Everyone I’ve relied on is someone I’ve been close to for years – they are family to me.
I changed a few plans: postponed all the social visits I was going to make to friends in Boston, and had some of them come visit me instead. I also decided not to spend the month between Thanksgiving and Christmas in Montpelier, Vermont, but instead to stay longer in the same place in Boston. I enjoyed a short visit to Montpelier for Thanksgiving and got a ride with one of my best friends, who joined me for the traditional vegetarian gathering (that I’ve been participating in for quite a few years).
Slowly getting better
An exercise at physical therapy – pulling a weight on a rope by bending my foot.
As of now, I’m in the middle of a six-week plan of physical therapy
and I’m able to start putting a little weight on my foot while wearing the walking boot. I’ve also learned to walk with regular crutches, go up and down stairs with them, and even walk with only one crutch! On Dec. 31 I’ll see the doctor again and hopefully the bone will have healed by then. I’m giving myself the whole month of January to heal more and get used to walking again before I leave for California. I was originally only going to stay in the New England winter for 6 weeks, but now it will be 10 weeks. I’m hoping to head to Los Angeles in early February, as long as I can walk pretty well by then.
Crutches in the snow
On days like this I don’t go out on crutches.
We didn’t have much snow in Boston until about a week ago, and once that happened it was much harder to get around. The crutches can slide easily if the ground is wet, snowy, or icy! So on snowy days I take a cab to physical therapy. On non-snowy days I can walk with crutches to the bus stop, get up into the bus (they lower the entry), and then walk about a block to the entrance of the physical therapy location.
I found out that you can buy special tips for your crutches that help with slippery surfaces, but they are expensive! I decided not to order them because I hope to be off the crutches in a few more weeks anyway.
I’m so glad my work is online!
I’m still working on my two book projects and that’s something I can do with my laptop in bed. So I’m not missing any work – another benefit of working online.
It did take a lot of time to research, plan, order the Flexleg and the knee scooter, go to physical therapy, and think about how I would get places. But since I wasn’t doing much socially, that’s where the time came from. It didn’t impact my work much at all.
All technology is assistive technology
Slide from my talk at Internet Librarian.
Ironically, during my conference talk at Internet Librarian (the reason I was in Monterey), I mentioned a really interesting article: “All technology is assistive technology.” It makes the point that we all have times of dependence and independence at different times in our lives, and even eyeglasses are assistive technology, so it’s really important to pay more attention to making all design (physical and virtual) accessible. I was mentioning it in the context of a talk about interactive book apps and showing how many of these apps benefit people with various disabilities.
Little did I know that I would soon experience a temporary disability myself! That’s part of the reason I’ve been interesting in trying all these different devices (knee scooter, hands-free crutches, cane, boot). I’m interested in all kinds of technology gadgets and I believe that everything in our world should be designed with accessibility in mind. It benefits everyone!
10 good things about having a broken ankle
1. Everyone opens doors for you.
2. Coffee shop workers bring your items to your table for you. (Luckily there are two coffee shops less than a block from where I’m living).
3. Your housemate does your laundry for you, since you can’t get down the basement stairs.
4. Your housemate picks up groceries for you. This saves money because you only get the items on your list (no last-minute temptations).
(My housemate Melissa is one of my best friends. I’m lucky to have her mothering me!)
5. You spend less money because you’re staying home more. (This helps offset the expenses of co-payments, taxis, Flexleg rental, & scooter rental).
6. Everyone tells you stories of their past injuries, so you realize you’re not alone.
7. You get more done on the books you’re writing because it takes your mind off being injured and you’re home with your laptop anyway.
8. You develop more empathy for people with permanent mobility problems. (So many out of order elevators on the Boston MBTA! Crutches in the snow & ice? Forget about it).
9. You have time to catch up on fun reading, movies on Netflix, and music playlists you made long ago.
10. You learn to be patient because it takes so long to heal. (Actually I haven’t learned that – I can’t wait to walk normally!)
Resources that helped me