Finally, the day came for surgery on my ankle. It was Thursday, 12th Feb, 2026. Right ankle tibiofibular (syndesmosis) ligament fixation. In other words, adding some bits to my ankle to get the bottom of my tibia and fibula into the right position (and keep them there) so that my ankle ligaments can heal correctly.
This process would include drilling holes through the bottom of the bones, so I would be put under general anaesthesia.
The afternoon before, the anaesthetist, Dr. Nagashima, came to have a chat about the anaesthesia.
“As per your schedule, 7:30pm is the latest you’re allowed to have food today, in preparation for your operation. About 10-20% of people experience nausea from general anaesthesia, so this is a precaution for that,” he explained.
“We’ll also inject local anaesthetic, nerve blockers, into the nerves in your lower leg. You’ll not be able to feel or move your foot for a couple of days afterwards.”
This would be the first time I’d ever had general anaesthesia. I was mildly nervous. Quite irrationally, I was quite nervous about the fact I’d be intubated. Irrational in the sense that I’d be unconscious, so what did it matter what they put down my throat?
In the evening, a nurse came and informed me it was time for my pre-operation shower.
“We’re required to make sure you’re showered the night before an operation,” she explained.
She carefully wrapped my splint in a plastic bag, and we trundled off to the spacious bathroom. She hovered around me as I undressed, making sure I didn’t fall over while balancing on one leg as I removed my hospital pyjamas. It wasn’t until I had hopped naked, with the help of a walking frame, into the bathroom and sat down, that she left me to it.
“If you need anything at all, press the nurse call button,” she said as she left the shower room.
Later on, she came back in, and helped wash my injured foot.
“Have you washed your feet since the accident on the 8th?” she asked.
It was now the 11th, and I’d not had a shower till then. So she got stuck in, scrubbing my leg and foot, in between the toes.
It was a humbling experience. It’s not often that I find myself completely dependent on someone else for the basics of life.
That night, I had a video call with Haidee, Rowland, and Kylee.
I shared my apprehension with general anaesthesia. Rowland had experienced general anaesthesia for a wisdom tooth extraction previously. “It’s awesome. You go to sleep, and you wake up with everything done,” he said.
This made me feel a bit better about it all.
The next morning, a nurse came with some pre-operation IV drips. One was electrolite fluids, another an antibacterial drip.
Surgery was scheduled for 11:30am
At 11am, the nurse hurried in.
“The theatre is ready for you, so let’s go.”
I gingerly got myself into the wheelchair and we wheeled down the hallway to the elevator. A few sliding doors later, we rolled into a beautiful, sparkly new operating theatre. Dr. Tsujino, the animated leg and foot surgeon, was busying himself with preparations. The anaesthetist from yesterday greeted me and explained the process.
“Lie down on the table here,” he said. He had a soothing voice.
“We’re just going to give you some medicine to make you feel relaxed,” he continued, as he hooked up a line of something to my IV line in my arm. I considered asking him what it was, but decided it’d just go with the flow.
It didn’t take long to feel relaxed.
Shortly after, he moved a mask over my face, and I think he said something like “we’ll be putting you to sleep now, so just…”
And that’s the last I remember until at least two hours later, when I woke up in the recovery monitoring room, now dressed in different pyjamas, hooked up to several monitoring devices and another drip, this time with a bit of glucose in it.
A bit later, Dr. Tsujino raced in with his usual haste.
“Good to see you’re up,” he said, as he handed me an x-ray of my ankle, now replete with extra bling. He seemed to be in a hurry. He left as soon as he handed me the x-ray.
In the end, it he’d decided to go with three syndemosis tightropes. I’d learn later that this is quite rare. I hope to get a chance to ask him about the decision process, and overall how he felt the surgery went.
At this point, I felt no pain. I couldn’t move my toes, but that was to be expected, according to Dr. Nagashima, the anaesthetist.
I was tired. I dozed on and off until night time, and then couldn’t sleep. I wasn’t used to doing nothing, sleeping during the day time…
The next day, I was moved back to my old room.
It was here that I would spend the next 24 hours or so in the pain cave. That lonely, private, dark place of nerve blockers slowly wearing off, and the sharp and blunt trauma of significant surgical invasion slowly squeezing and pressing and pounding my ankle.
I was now on a regimen of pain killers. Loxoprofen three times a day. The nurses took advantage of the IV port still in my arm to administer acetaminophen via IV drip in between the loxoprofen.
This only took the edge off.
The bandage around my splint and ankle felt like it was squeezing my foot off.
“It’s not very tight at all,” said the nurse when I asked if it was too tight.
My body was in rebellion against the abuse it had sustained in the operating theatre.
Amongst it all, Haidee, Rowland, and Kylee came for a visit. It was great to see them, and it took my mind off the pain for the short 15 minutes allowed for visits – family only!
The darkest depths of the pain cave came at around 9pm. I’d had another round of acetomenophen via drip, but my ankle was still angrily pressing at the gauze around it
I called the nurse. She re-applied the gauze, looser this time, but it still throbbed. Nothing seemed to take away the pain.
Writing this now, detached from the situation, I can say the pain was ‘only’ about a 6 out of 10. It wasn’t curl-up-and-die sort of pain. But it was a pain that took a sledge hammer to my spirits. For the first time since the accident five days ago, I felt properly sorry for myself. I cried. I didn’t want to be here in this situation any more.
The pain and tears brought me back to a time during my cross-China skateboard journey in 2008. It was in Turpan City in the Gobi Desert, May 15th, 2008. I didn’t write about it at the time, but I was in a dingy inn, sweltering heat, and I had a splitting migraine. I was tired and burned out and hurting.
I cried and I cried.
It was all too hard. Too hard to keep moving across China.
At the same time, bound to the goal I’d set, enforced by no one but myself.
This time, with a throbbing ankle that had been cut open by another person, drilled into, and immobilised, I felt a similar sort of helplessness mixed with throbbing pain. Wanting to walk out of the hospital away from the pain, but unable to do so, this time not because of a self-imposed enforcement, but something that was imposed upon me.
I cried and I cried, sobbing into my elbow, trying to muffle the sobs lest my ward roommates heard me.
The nurse had offered to give me another painkiller dose after midnight if I was still not sleeping by then.
“I’ll come by and check, and if need be, we can administer a suppository, which will act fast,” she said.
The last time I looked at the time it was 12:30pm. The next time I looked, it was 4:10am. I don’t know if the nurse had checked, but finally the sleep had come, just like the sleep had come back then in Turpan in 2008.
The morning gave me a new perspective and clarity. I played around a bit with how my splint was sitting and figured out that propping my heel up a bit would relieve pressure on the top of my foot.
Haidee messaged and said she’d drop by to visit; the strict hospital visitation rules stated no more than one 15-minute visit per day, and only by family, two people max. It was so good to see her and catch up.
Physical therapy also started today. Just a quick 15 minute session in the 1st floor therapy room, but it was an absolute joy to move my body again, feeling the familiar burn of muscles worked, as I squeezed a rubber ball between my thighs 20 times.
I committed to doing five laps of the ward in my wheelchair per day for as long as I was confined to the wheelchair. I was hearing from the likes of Charlie, who had also undergone surgery (much more significant than mine), spent a decent chunk of time in a Sapporo hospital, and had a much tougher time with pain than me, and was coming out the other end with success. A sense of purpose was starting to creep back into what had quickly become a very institutionalised, isolated existence.
I was starting to crawl out of that dark pain cave that had swallowed me for the past 36 hours, and was starting to see an exit.
2 thoughts on “Hokkaido Ski Accident (Part 3): The surgery pain-cave”
Yay for being able to see the exit! I’m sending healing vibes and a big hug 🤗
Cheers Timbah! Moving closer to that exit every day!