Ankle injury -- unrealized -- common for RA / diabetes patients?:

#1

Hey everyone. Hope everyone is enjoying the new year so far. Well, Tuesday morning I woke at 6 am with my right (good) ankle aching, but I didn't think anything of it. Got dressed for work, but my boots (rubber sole, flat) on and the pain went away.

Went about my day. Then at lunch, headed to Target to pick up some stuff. Got off from work around 5:15 pm, driving home I was unable to brake with my foot due to the pain. By the time I got home at 6:00 pm, I pull off my boot and sock and foot was hugely swollen. I couldn't walk on it.

I started taking extra prednisone and my nighttime Vicodin. Neither did anything for the pain. By this time I was in tears--used topical pain relief creams--still no relief.
Prednisone sent me to the restroom three times that night and I had to hop--was not pretty.

Wednesday morning I had to call the ambulance to take me to the hospital. ER doctor said my ankle wasn't broke, but it was a bad sprain. He swears I wrenched it or twisted it. I never remember doing anything like that to it.
Again, this is a my good ankle, my left ankle is my "bad" ankle and I've had surgery on it for torn ligaments. Now, I'm off from work, on bed rest, on crutches, icing, ace bandaging my ankle.

My rheumy postponed my Remicade for two weeks due to insurance (new year)--so I'm going to have to hop there tomorrow (Friday) for my monthly drugs.
I'm wondering--is this normal to hurt yourself and not know it with diabetes and RA?

I've always known when I've injured myself before--at first I assumed with the cold weather that "Uncle Arthur" was just acting up--Rheumatoid Arthritis rearing its ugly head. But this is weird--like Twilight Zone weird.

Any thoughts? Has anyone had this problem before?

#2

Rheumy doesn't agree with ER doc...gave me an extra-extra shot of steroid injection with my Remicade infusion. Wants to watch my ankle for the next 5 days--if it doesn't improve, an MRI will be ordered and maybe another bone density scan to check my bones. Possibility a hair line fracture. Yikes.

Still swollen, can't put any pressure on it and it's turning blue. Rheumy's concerned that the prednisone and Vicodin did nothing Tuesday night for the pain--it was like I was taking candy. :-(

High on steroids now and sweating like a pig. Going to rest now.

#3

Hi Again Kate!!

Aw, sorry that you started your New Year with an injury. Geez, you're BG must be ridiculous with the Prednisone and steroid injection.

You and I are quite the pair but I decided to have a bone fracture in the fall when so many Family Birthdays were going on.:P Similar to your case, I got out of bed in the morning, took a few steps and felt a stabbing pain in the right side of my right foot. I've never had a sprain or broken bone before, although I've always had weak ankles. I don't know how you could have walked that day at all with a fracture or a sprain.

My Hubby had purchased a walker, cane, crutches and a used electric wheelchair
before, just in case. I have used the walker and cane on bad days so far, but I could only use the crutches for this fracture. I called my Rheumy the next day and he squeezed me in for an appointment a couple days later. My foot was swollen and bruised. I had an exray and in about an hour we looked at and discussed the exrays. Sure enough I had a stress fracture. I'm on my feet a lot of the day and steroids don't help any.

I'm not sure about Diabetes but RA and fractures are connected.

http://www.niams.nih.gov/health_info/bone/Osteoporosis/Conditions_B...

http://www.arthritistoday.org/news/rheumatoid-arthritis-fracture-ri...

My foot healed well, so we were thankfully able to make our trip to Halifax, 2 months later. I kind of have a fear of walking and exercising on my feet now. I sure hope that doesn't happen again, although I know it will, as I get older.

Whichever you have, sprain or fracture, I hope that you will be out of pain soon and it will be nicely healed. Let us know what happens. :)

#4

Thanks Terrie for the heads-up. So sorry to hear about your fracture. Yikes. Just so strange, isn't it?

The pain patches the rheumy wrote for me weren't covered by insurance and were just too expensive for me to buy (over $600 for a 30 day supply). So I'm still popping prednisone and Vicodin, resting as much as I can. I can place a little weight. But there's a throbbing and swelling that accompanies it when I do.

I think I'm still going to have to get the MRI. With all the weight loss I'm having (not even trying at this point) there may be changes with my bones--and there's always the looming osteoporosis possibility.

Thanks so much for the information.

I'll keep you posted.

k

#5

http://www.niams.nih.gov/health_info/bone/Osteoporosis/Conditions_Behaviors/osteoporosis_ra.asp

http://www.arthritistoday.org/news/rheumatoid-arthritis-fracture-risk172.php

#6

Ouch! I wrote a note to you and it disappeared.

I thought it was strange too but obviously it's not with these conditions and meds unfortunately. Thanks Kate!

OMG! $600!!!? I'd suggest they shove those patches where the sun don't shine. Outright robbery! On the other hand, I hate to hear that you are popping Prednisone. I haven't tried Vicodin.

With my fracture I rested, with my foot higher than my heart, took a couple extra Pred. and Tramadol daily, wrapped an ACE bandage around my foot snug but not tight. I also bought a 1 size larger(to accomodate the ACE) pair of slippers with lots of soft cushioning inside and used the crutches. I was told not to use them because of the RA in my shoulders but I didn't have a choice. I couldn't use ice or even frozen peas since they burn my skin.

Yes certainly, an MRI or exrays if it's quicker, is needed now. I should get another bone scan also. I had Osteopenia some years ago in my left hip,
so I'm pretty sure that I have more elsewhere and Osteoporosis.

I forget if I said anything more in my other note, so this will do for now.

You're Welcome! :) Take care and be Good to yourself.

Oh, I put the links again since I noticed the originals didn't work. Strange!
#7

Thanks Terrie. I was having problems yesterday with my computer so I thought it was on my end why I couldn't open the links. Yeah, I'm just babying it now.

I have a couple of friends with osteopenia so they can be great resources as well.

When it rains, it pours.

k

#8

Sorry to hear. I believe ankles are one of those things that can get sore or damaged very easily. I broke a bone in my foot just walking before I started getting all my health issues figured out. You might have inflammation, like you said from the RA. Best way I’ve noticed to alleviate any pressure is by wearing a compression ankle brace and doing light stretches at night. Just get the range of motion back and the pain and swelling tend to take care of themselves. It will heal, sometimes random things happen to the body. Consistent light stretches (physical therapy in a way) to increase range of motion, some type of supportive ankle brace, rest and get your inflammation under control.