Preparing for Ankle Surgery Recovery
By Jillian Banfield
In December 2023, I had my left ankle joint replaced after living with rheumatoid arthritis in that joint for 38.5 years. Ten years prior, I had the talonavicular joint in my left foot fused.
What follows is my personal experience with the approach I took to making my recovery time as comfortable as possible. This approach was mostly informed by the poor experience I had after my last surgery since there had been little guidance about how to set myself up for success. I spent time searching for this type of guidance before my most recent surgery but also couldn’t find the level of detail I was looking for.
My financial privilege and a supportive partner were the most important aspects of this approach. It is expensive to have surgery, even when that surgery is paid for by the public health care system. It is difficult to have surgery without having a full time caregiver available to assist with recovery.
Note that I provide links below to the items I purchased. I typically don’t use Amazon but it would’ve been very difficult to get all of these items locally.
Pre-planning
I made a spreadsheet with “to do”, “to get”, and questions for surgery and anesthesia to ask at my pre-op appointments. For the “to do” items, I put in general timelines of when things needed to be completed. For example, I made sure my COVID vaccine was 2+ weeks before surgery for optimum protection.
I also had a lot of items for the day before surgery, such as moving my toiletries and clothes downstairs. Having this as a Google spreadsheet allowed me to easily add items as I thought of them in the months leading up to surgery.
Mobility aids
Knee scooter. My surgeon recommended this at our first appointment, so I purchased one about 2 months before surgery so that I could practice with it. These are available to rent from various places, but not for loan from the Red Cross in Nova Scotia. There are a wide variety of types of knee scooters. I bought one with 4 wheels for stability.
Although I didn’t plan to go outdoors with mine, I bought one with “all terrain (air-filled)” tires in the front and solid tires in the back. The air-filled tires make bumps and thresholds much more manageable. Mine has just a back break on the right handlebar. I had to order this from Amazon because it wasn’t available locally.
I bought a basket to attach to the front of the scooter, which allowed me to transport things like snacks in containers. I also had a small pouch attached to the handlebars that is technically for carrying a water bottle on a bike. I used it to transport my water bottle to refill in the kitchen, or my phone if I didn’t have pockets.
Crutches. I bought these rather than rent them to save some fuss, but I also managed to avoid using them, thanks to the knee scooter. Given the arthritis in my hands and elbow, and the extreme pain I had when using crutches after my previous surgery, the knee scooter felt like a miracle.
Boot cast. This is required after time in the cast and has to be purchased. I was sent to a private physio clinic before my surgery to get fitted for the boot cast and they assisted with putting the cost through my insurance. I still had to pay for some of it myself. It’s sometimes possible to find these on Kijiji but make sure the size is right for your foot.
Bathroom
Grab bar. Our small half-bathroom on the main floor of the house had enough room for me to back in my scooter. I could then lift myself on/off the toilet by using both the grab bar and holding onto the sink. This would be much more difficult without the grab bar.
Hand towel for grab bar. I made a small hand towel from a worn linen bed sheet that I could tie onto the grab bar, allowing me to wash and dry my hands before rising from the toilet.
Small towels. For taking a bird bath in the half-bathroom on the main floor of the house. This was easier than managing a full bath towel. I made these by cutting up a worn linen bed sheet.
Small rolling cart. I bought a very narrow cart with three levels and wheels so that I could put my essential toiletries in the bathroom and move it around as needed.
Shower chair. I already had this from my previous surgery and started using it again a few months before this surgery to help cope with the pain I was experiencing. This practice also helped me understand how sturdy the chair was, so I was less worried when I went to use it for the first time after surgery.
When I had my cast on, I would sit on this chair in the shower, with my leg resting on my scooter just outside the shower. Between the chair itself and the scooter handlebars, I had enough stable points to hold onto as I transferred between the scooter and chair.
I suspect I’ll keep using it even after I recover from this surgery, so it’s definitely a worthwhile investment.
Bed
Bedside nightstand. I got one with 3 drawers and a built in electrical outlet (2 plugs + 2 USB). There was plenty of space on the top to put all the pill bottles I needed access to after surgery, as well as space for a small lamp, a stack of books, and a water bottle.
It was very helpful to have multiple charging stations within easy access and a spot to plug in the lamp. The drawers are large enough to hold a few changes of the sweatpants, hoodies, and wool base layers that I lived in.
Pillow wedges. I bought one that allows me to put my leg up without having to rely on stacking pillows. I used this for months before surgery as I iced my sore ankle at the end of the day.
I also bought a modular set of 3 pillows that allow me to sit up easily in bed. The bed I used does not have a headboard, so it would’ve been especially uncomfortable to try to prop up enough pillows against the wall. This set includes a small pillow that can be used as a backrest or headrest. I propped my pillows against it and it was very comfortable to use throughout the day.
Bed rail. This was an Amazon recommendation and a really good one, it turns out. A small bed rail gives me something to grab onto as I get up to get on my scooter or when I return to bed. Parking my knee scooter next to it also allows me to use them together to do some stretching of my legs and arms before I get back in bed.
iPad stand. I bought a stand with a gooseneck that can hold my iPad or phone. I put my iPad in it and typically used it at night when I couldn’t sleep and needed distraction. It was helpful to have the stand so that I didn’t have to figure out how to arrange yet another thing on the bed. And, given that I had to lay on my back, it would have been hard on my neck to turn and look at it propped on a bedside table.
Tray with legs. I already owned this, mostly for taking my laptop outside to work during the summer. It turned out to be a useful tool for my partner to be able to bring meals to me in bed.
Clothes
My surgery was during a cold time of year, so I stocked my bedside table with wool base layers that were comfortable to wear during the day and doubled as pyjamas. To avoid cutting up a pair of pants after waking up with a cast on my foot, I bought a couple of pairs of wide-leg sweatpants from The Last Hunt.
I have a pair of “indoor shoes” and put on the right one every time I got up from bed. This was partly to protect my right foot, which also has arthritis damage, and partly to help with traction as I glided around on my knee scooter.
Food
I bought a small deep freeze.
I started making extra food ~6 months in advance. Financial privilege allowed me to buy extra ingredients, storage containers, and to have the time to prepare food. It was hard on my body to do this extra work, but worth it to have ready-made meals after surgery.
I made a spreadsheet to track what I put in the freezer, including the type of meal, how much of it, a description of its container, and the source (cookbook or website). Since my partner was the one retrieving the items, I tried to make the spreadsheet comprehensive and label each container well before it went in the freezer.
I bought frozen vegetables that are easy to incorporate into meals, like peas and blocks of spinach.
My mom took me to Costco prior to surgery so I could get some larger quantities of basic things, like cereal, crackers, and tomato sauce, so we’d have to do less grocery shopping for a while after surgery. I used the mobility scooter that our local Costco has because it wasn’t possible for me to walk around such a huge store.
After surgery, we put some small plastic containers on the counter along with some snacks that I could put in them as needed. Cereal and nuts were easy to turn into a little snack pack that I could put in my scooter basket and take back to bed.
Entertainment/distraction
I used the library to put books on hold and pause them until close to my surgery time so a stack would be available right away.
I also used the library to put e-books on hold so that physically going to pick up/return books would be less of a barrier during recovery.
I made a spreadsheet of ideas of things to watch. The Kanopy service through the library sends an email every Friday with suggested movies, so this was a helpful starting point.
I have an iPad with subscriptions to Netflix and Spotify. It was very helpful for the middle of the night when I couldn’t sleep due to the uncomfortable position and I needed distraction from that.
Bluetooth over-ear headphones. I had Bluetooth earbuds for work, but it can be quite uncomfortable to have something in my ears for hours. The headphones are easier to wear for longer periods and I can fall asleep with them on. I bought a less expensive pair, as I wasn’t too concerned with portability or top-notch noise cancellation.
Other
Small wooden wedges for the thresholds on the main floor of my house. My step-dad made these for me, so they were the specific heights needed for the various thresholds of my old house. These weren’t absolutely necessary, but they made using the scooter easier and more comfortable, especially when my foot felt very tender for the first few days after surgery.
Waist gait belt. A wide belt with handles that goes around your midsection, allowing someone to help you get up/sit down without hurting you or themselves. A physiotherapist I saw before my surgery casually asked if I had one and I’d never even heard of it.
I bought a “universal” one that ended up being too loose for me, but I was able to use my sewing machine to cinch it enough to fit me. This was helpful to wear in a few situations - such as when I first got home and needed to make it from the car into the house on my knee scooter. My partner was able to safely hold on to me in case I needed it.
We also used it as part of the journey of getting me upstairs to shower. I went up the stairs on my bum and when I got to the top, he helped me get up on a chair by using the belt.
Reacher/grabber. These came as a set of two for some reason, so I just kept one on each side of my bed. I can’t lift a lot with them or be very precise, but they were somewhat helpful for retrieving or moving things a bit outside of my reach.
What I didn’t do
I considered buying a cover for my cast for showering. These would probably simplify showering, but we made it work with a series of plastic coverings, towels, elastic bands and clips. I didn’t want to end up with too many things that I couldn’t repurpose after my recovery. My time in a cast was only 3 weeks and I only showered every 4-5 days. If my cast time were longer, I would’ve been more motivated to buy one of these covers.