At the end of my first week back to work at almost full-time, I am exhausted. Between hauling myself around the hospital campus and the general work of showering and dressing, I might sleep until Sunday. It does feel good to be getting back to normal, however, and I have made huge strides in comfort and recovery over the past week.
Last night, I decided to try a Pilates exercise video and was surprised to find that I was able to do it with moderate modifications. My hamstrings are incredibly tight on both sides; touching my toes was impossible. The stretching and strengthening, however, felt great. One of my goals for recovery is to increase core and hip strength. While I am an efficient runner, I tend to turn side to side, especially as I get tired. I also tense my shoulders the longer I run. In the marathon, this can make minutes of difference. So as I have the time to work on my foundation, I am focusing on improving hip strength (to improve my knee drive) and strengthening my shoulder (an old injury) so that my arms swing forward, not to the side.
As for walking, I am starting to be able to move very well with crutches and improving without them. I am noticing, however, that I am rolling off the outside of my foot, as opposed to landing in the center and rolling off my big, second and third toes. This is definitely something I need to bring up in PT on Tuesday; I'm very nervous that any biomechanical shift in my stride is going to cause a chain reaction of injury.
My goal for this weekend is to continue to work on getting the swelling out of my "cankle" and ride the bike for 15 minutes a day. Even though there is no resistance, the act of getting dressed in workout clothes is very comforting.
Friday, April 30, 2010
Wednesday, April 28, 2010
3 Weeks Post Op
Today marks 3 weeks from surgery and I've come a long way, even from last week. I am down to almost no pain, save for occasional discomfort when I put too much weight on my left foot. I am "walking" on crutches, which means that I am mimicking a true step, while letting the crutches bear most of the weight. When I'm home, I am plodding around without crutches at all. I look a little less like a pirate than I did last Friday, but am still very stiff legged. My calf is much less tight, but I still can't push off my toe, so I'm forced to step from my heel. That said, I am much more comfortable in shoes than in bare feet, a first for me. My ankle is still swollen, but much better than it was. Thanks to the snowstorm, I was forced to explore which close-toed shoes would fit my fat foot and was happy to discover that my work clogs would go on.
And now for some pictures...(Medial and Lateral Incisions respectively)
And now for some pictures...(Medial and Lateral Incisions respectively)
Tuesday, April 27, 2010
Snow+Flip Flops+Crutches = Disaster
This morning, we woke up to a surprise snowstorm. Well, not really a surprise, as it was in the forecast, but surprise in that it's April 27th. Regardless, I am very thankful that I didn't have this surgery in the middle of winter. Flip flops in the rain are bad enough. Flip flops in snow are downright awful.
Despite the weather, this week finally feels like recovery. I had a great PT session yesterday, focusing on walking with the aid of my crutches on both feet. Prior to PT, I was tapping my left toe down. Now, I am doing a true heel strike and rolling through to my toe. Although this slows me down incredibly, it has done wonders to loosen up my calf.
I will be three weeks post-op tomorrow. I am walking tenderly, riding a bike for a few minutes a day and have returned almost full-time to work. This requires a handicap permit (I usually walk and bus) and some creative carrying skills with a purse, but getting back to a regular schedule feels great. For the first time since surgery, I am starting to think about running again. The weather was beautiful here yesterday, and I was gazing longingly at sidewalks and runners. Soon enough, soon enough.
Despite the weather, this week finally feels like recovery. I had a great PT session yesterday, focusing on walking with the aid of my crutches on both feet. Prior to PT, I was tapping my left toe down. Now, I am doing a true heel strike and rolling through to my toe. Although this slows me down incredibly, it has done wonders to loosen up my calf.
I will be three weeks post-op tomorrow. I am walking tenderly, riding a bike for a few minutes a day and have returned almost full-time to work. This requires a handicap permit (I usually walk and bus) and some creative carrying skills with a purse, but getting back to a regular schedule feels great. For the first time since surgery, I am starting to think about running again. The weather was beautiful here yesterday, and I was gazing longingly at sidewalks and runners. Soon enough, soon enough.
Saturday, April 24, 2010
A marathon is how long?
Whether it's the blood thinner or the cumulative effect of a few weeks of zero physical activity (seriously, how do people choose to be couch potatoes?), I am feeling seriously out of shape. Hauling myself around by my arms takes a lot of effort, but it's not exactly tantamount to a jog, or even a brisk walk. I bought a gentle yoga DVD today, but only got as far as the deep breathing. Turns out, despite being able to stand, balancing and stretching are advanced standing skills. I did manage to do 10 minutes on the stationary bike without discomfort. My left foot still hangs there, close to lifeless, but is happy to rotate while the right leg pushes.
I typically get annoyed at people who lack respect for the effort demanded by the marathon. Whether you are a 5 hour or a 3 hour marathoner, it will take everything you have and then some. That frustration is growing daily, both as we approach the Vermont City Marathon here in Burlington and as I get farther from running shape. From friends who have maxed out at 4 mile runs and consider themselves "ready enough" to the girls I overheard on campus this week, plotting how to cheat at the relay (don't get me started), it seems like everyone wants the easy way to the end of 26.2. The truth is, there's no easy way to get there. 26 miles is a damn long run. The .2 is just plain mean.
Right now, a fall marathon seems thousands of miles away. A few pirate-worthy steps are a long way from the finish line...
I typically get annoyed at people who lack respect for the effort demanded by the marathon. Whether you are a 5 hour or a 3 hour marathoner, it will take everything you have and then some. That frustration is growing daily, both as we approach the Vermont City Marathon here in Burlington and as I get farther from running shape. From friends who have maxed out at 4 mile runs and consider themselves "ready enough" to the girls I overheard on campus this week, plotting how to cheat at the relay (don't get me started), it seems like everyone wants the easy way to the end of 26.2. The truth is, there's no easy way to get there. 26 miles is a damn long run. The .2 is just plain mean.
Right now, a fall marathon seems thousands of miles away. A few pirate-worthy steps are a long way from the finish line...
Friday, April 23, 2010
Baby Steps
Today was a big day. I took a shower without any help, drove my car to a meeting at work and took my first steps. Yes, you read that right, I took some steps unassisted by my crutches. I almost cried, not from pain, but from relief that someday soon, all will back to normal (ish). My gait isn't pretty; my calf is incredibly tight, so I look a bit like a pirate just off the ship. I'll take the progress, though.
I am still taking it painfully easy. Because my right leg is so sore from supporting my whole body, my major focus right now is stretching and foam rolling that leg, while working on flexibility in my left leg so that my gait becomes less pirate, more toddler.
I am still taking it painfully easy. Because my right leg is so sore from supporting my whole body, my major focus right now is stretching and foam rolling that leg, while working on flexibility in my left leg so that my gait becomes less pirate, more toddler.
Thursday, April 22, 2010
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Wednesday, April 21, 2010
2 Weeks Out
The last week has flown by, for reasons good and bad. On Thursday of last week, I traveled to North Carolina to attend the annual research conference at UNC-Chapel Hill's School of Government, where I got my master's degree. I had two short flights (less than one hour each) and clearance to travel, and made the decision to attend. As soon as the flights got underway, however, it was evident that perhaps I was not ready to fly. My calf started throbbing and I was in the most pain I've been in through my entire recovery.
While sitting at the conference, my leg and foot started to swell considerably, so badly that my flip flop would not fit on my foot. Because I had just flown and was post-surgery, I sought care at UNC's Emergency Room. Within hours, an ultrasound would show that I had 3 clots in veins in my calf, and I was admitted to the hospital. It was terrifying to be in North Carolina, hundreds of miles away from my family, with a potentially life threatening condition. For those who are not familiar, deep vein thrombosis (DVT) is a very dangerous condition. If a clot breaks off, it can travel to the lungs, causing a pulmonary embolism.
During my hospital stay, I received excellent care. In fact, the caring nature of the staff brought me to tears every time. My housekeeper brought me flowers "because my momma was too far away." My nurses fussed over me. My doctors were patient and thorough, realizing that for me, information helps to calm me down. When I was finally discharged, I had a team of amazing friends who held doors and crutches, carried my bag and generally took care for me for 3 days. Two of them drove me from North Carolina to New York so we could avoid more pain on my return flight.
I am now on a blood thinner to help manage the clot. With this comes frequent doctor's visits to check my INR (essentially blood thinness) and the perpetual panic that every cough or throb in my calf means a clot is on the move towards my heart. This morning, for example, I woke up in excruciating pain and could not get comfortable. Luckily, I had an appointment, so the nurse assured me that pain and swelling is normal with clots, but not necessarily indicative of a medical emergency. Still, I look forward to the day when a cough is just a cough.
From a surgical recovery perspective, I am doing alright. On the suggestion of the Physical Therapist I had in North Carolina, I've started to do a 4 point touch; basically, my left foot taps on the ground as I walk. Two nights ago, I took a few really good steps heel to toe with the help of my crutch. I am also doing my gas pedals and alphabet exercises regularly. It's still hard to think about running again, especially now that I need to be careful about falling. I had hoped to use cycling and swimming to help build my cardio before starting running. Now, I'm reticent to head out on my road bike because I don't want to fall. My incisions look as good as can be expected; they are flattening out and itch like crazy.
In all of this, I believe there are lessons to be learned. From my perspective, I don't feel that the risk of blood clots was adequately communicated to me by my post-op team. Now that I know the symptoms, it seems possible that I had the clot for a while before I sought care. When I had my post-op appointment, no vitals were taken and my complaints of throbbing in my calf was diagnosed as normal post-op pain. To take responsibility, however, I chose to be aggressive with recovery, despite having struggled from Day 1 post-operatively. While someone who had not struggled with anesthesia, pain and vomiting may have traveled successfully a week post-op, I did not.
At this point, I'm just desperate to return to some semblance of normal life. While I would love to be running again, right now I would take walking without crutches in minimal pain. In thinking about the experience and the chance that I might develop symptoms in my right leg, I am resolute that I would not opt to do this surgery again. I would rather give up competitive running than go through this again. For those considering this surgery, I don't say this to talk you out of the procedure, but simply to share my opinion. I love running more than almost anything, but I value my life and mobility more. The complications resulting from this surgery are not something I am willing to risk again.
While sitting at the conference, my leg and foot started to swell considerably, so badly that my flip flop would not fit on my foot. Because I had just flown and was post-surgery, I sought care at UNC's Emergency Room. Within hours, an ultrasound would show that I had 3 clots in veins in my calf, and I was admitted to the hospital. It was terrifying to be in North Carolina, hundreds of miles away from my family, with a potentially life threatening condition. For those who are not familiar, deep vein thrombosis (DVT) is a very dangerous condition. If a clot breaks off, it can travel to the lungs, causing a pulmonary embolism.
During my hospital stay, I received excellent care. In fact, the caring nature of the staff brought me to tears every time. My housekeeper brought me flowers "because my momma was too far away." My nurses fussed over me. My doctors were patient and thorough, realizing that for me, information helps to calm me down. When I was finally discharged, I had a team of amazing friends who held doors and crutches, carried my bag and generally took care for me for 3 days. Two of them drove me from North Carolina to New York so we could avoid more pain on my return flight.
I am now on a blood thinner to help manage the clot. With this comes frequent doctor's visits to check my INR (essentially blood thinness) and the perpetual panic that every cough or throb in my calf means a clot is on the move towards my heart. This morning, for example, I woke up in excruciating pain and could not get comfortable. Luckily, I had an appointment, so the nurse assured me that pain and swelling is normal with clots, but not necessarily indicative of a medical emergency. Still, I look forward to the day when a cough is just a cough.
From a surgical recovery perspective, I am doing alright. On the suggestion of the Physical Therapist I had in North Carolina, I've started to do a 4 point touch; basically, my left foot taps on the ground as I walk. Two nights ago, I took a few really good steps heel to toe with the help of my crutch. I am also doing my gas pedals and alphabet exercises regularly. It's still hard to think about running again, especially now that I need to be careful about falling. I had hoped to use cycling and swimming to help build my cardio before starting running. Now, I'm reticent to head out on my road bike because I don't want to fall. My incisions look as good as can be expected; they are flattening out and itch like crazy.
In all of this, I believe there are lessons to be learned. From my perspective, I don't feel that the risk of blood clots was adequately communicated to me by my post-op team. Now that I know the symptoms, it seems possible that I had the clot for a while before I sought care. When I had my post-op appointment, no vitals were taken and my complaints of throbbing in my calf was diagnosed as normal post-op pain. To take responsibility, however, I chose to be aggressive with recovery, despite having struggled from Day 1 post-operatively. While someone who had not struggled with anesthesia, pain and vomiting may have traveled successfully a week post-op, I did not.
At this point, I'm just desperate to return to some semblance of normal life. While I would love to be running again, right now I would take walking without crutches in minimal pain. In thinking about the experience and the chance that I might develop symptoms in my right leg, I am resolute that I would not opt to do this surgery again. I would rather give up competitive running than go through this again. For those considering this surgery, I don't say this to talk you out of the procedure, but simply to share my opinion. I love running more than almost anything, but I value my life and mobility more. The complications resulting from this surgery are not something I am willing to risk again.
Wednesday, April 14, 2010
1 Week Out
Last week at this time, I was in la-la land, somewhere between the OR and the PACU. To be completely honest, this past week has been far more difficult than I was prepared for. Some of that was that anesthesia really took a lot of out of me; the other major part was that I was unable to tolerate the pain meds, so had to experience recovery on tylenol and ice.
Today, however, I started to get back to "normal" life. I went to work this morning and found out just how far my office is from the Peds Clinic on crutches. Normally, it's a 5 minute walk. This morning, it was a 25 minute adventure that left me breathless and soaked in sweat. I am learning quickly that many doors are heavier than they look and that walking should not be taken for granted. Luckily, once I got to the clinic, I put myself on an exam stool and scooted around. My leg is achy but not overly painful. The swelling in my foot is down as well.
This afternoon, my project is laundry, as I'm scheduled to travel to North Carolina in the morning. Surviving this morning gives me some confidence for tomorrow. I am going to have to swallow my pride and use the wheelchair service at the airport; there is no other way to tote my bag. My dependency on others is perhaps the hardest part of this whole recovery. I hate needing help or feeling like a burden. Over the past week, I have had to ask for help with everything. After the first day, I managed to use the bathroom without help, but even this morning Matt had to put my sneaker on for me. I cannot imagine having done this without the support of my parents, my sister or my boyfriend. My friend Katie who had ankle surgery last year, did much of her recovery alone and remarked last night that "you'll be amazed how resourceful you become." Indeed, I just used my right crutch to push the laundry basket around so I could load the washer.
I am finally starting to see how I'm going to walk and run again. Starting PT was encouraging, as was getting through this morning, sweat soaked as I was. Over the next few days, I need to work on getting the swelling out of my ankle and beginning to weight bear on my left foot.
Today, however, I started to get back to "normal" life. I went to work this morning and found out just how far my office is from the Peds Clinic on crutches. Normally, it's a 5 minute walk. This morning, it was a 25 minute adventure that left me breathless and soaked in sweat. I am learning quickly that many doors are heavier than they look and that walking should not be taken for granted. Luckily, once I got to the clinic, I put myself on an exam stool and scooted around. My leg is achy but not overly painful. The swelling in my foot is down as well.
This afternoon, my project is laundry, as I'm scheduled to travel to North Carolina in the morning. Surviving this morning gives me some confidence for tomorrow. I am going to have to swallow my pride and use the wheelchair service at the airport; there is no other way to tote my bag. My dependency on others is perhaps the hardest part of this whole recovery. I hate needing help or feeling like a burden. Over the past week, I have had to ask for help with everything. After the first day, I managed to use the bathroom without help, but even this morning Matt had to put my sneaker on for me. I cannot imagine having done this without the support of my parents, my sister or my boyfriend. My friend Katie who had ankle surgery last year, did much of her recovery alone and remarked last night that "you'll be amazed how resourceful you become." Indeed, I just used my right crutch to push the laundry basket around so I could load the washer.
I am finally starting to see how I'm going to walk and run again. Starting PT was encouraging, as was getting through this morning, sweat soaked as I was. Over the next few days, I need to work on getting the swelling out of my ankle and beginning to weight bear on my left foot.
Tuesday, April 13, 2010
It'sssss Alive! (Warning, a little gross)
Had my follow up appointment today and got to see my scars for the first time. The lateral scar? Not so bad. The medial scar? Gross. Warped from the dressing, swollen from the incision and yellow from the betadine scrub = one ugly calf. Dr. Slauterbeck was pleased with my progress and I'll see him on May27th for the go-ahead to run.
I also had my first PT appointment today. I was looking forward to it both because I wanted Lee's reassurance that everything is going to be fine, but also because I knew Lee would have "homework" for me. Our first order of business is getting the fluid out of my ankle joint, which is pretty swollen right now, so I have exercises for that. I also learned how to go up and down stairs, a critical skill in the coming weeks. I also worked on placing some weight on my left leg; far from standing, but it felt like progress.
I'm still surprised with how exhausted I am. After the two appointments, I was in tears from exhaustion in the car. I'm supposed to return to work tomorrow as well, with two appointments back to back in the morning. Not only am I not sure I can stand to do my job, I have no idea how to carry equipment back to my office. In hindsight, I wish I had taken two weeks off.
Now for some pictures. Too bad Halloween is so far away...
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I also had my first PT appointment today. I was looking forward to it both because I wanted Lee's reassurance that everything is going to be fine, but also because I knew Lee would have "homework" for me. Our first order of business is getting the fluid out of my ankle joint, which is pretty swollen right now, so I have exercises for that. I also learned how to go up and down stairs, a critical skill in the coming weeks. I also worked on placing some weight on my left leg; far from standing, but it felt like progress.
I'm still surprised with how exhausted I am. After the two appointments, I was in tears from exhaustion in the car. I'm supposed to return to work tomorrow as well, with two appointments back to back in the morning. Not only am I not sure I can stand to do my job, I have no idea how to carry equipment back to my office. In hindsight, I wish I had taken two weeks off.
Now for some pictures. Too bad Halloween is so far away...
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Monday, April 12, 2010
How to Take a Shower
Ingredients:
- 1 Jumbo Garbage Bag
- 1 Roll of Duct Tape
- 1 Boyfriend, terrified that I was going to slip on the bath mat
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- 1 Jumbo Garbage Bag
- 1 Roll of Duct Tape
- 1 Boyfriend, terrified that I was going to slip on the bath mat
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Blue Jean(s) Baby
Despite progress slower than I would like, I managed to get dressed in real clothes today, a test run for my big day tomorrow. Not only do I return to work part time, but I have a follow-up with Dr. Slauterbeck and will see my scars for the first time. I have been almost completely immobile since last Wednesday, so I hope that they look as good as Dr. Slauterbeck would like. This will also be a good picture opportunity, so I am excited to share those.
I also have my first PT appointment tomorrow and am lucky to be working with my friend Lee, who knew me prior to surgery and is also an avid triathlete. I hope we do some work with my crutches; right now, I am guarding my left leg, and my hip is paying the price. I have been working on placing my foot on the floor when I stand to brush my teeth or wash my hands, but my leg is unnaturally straight. Hopefully I will get some flexibility back in my calf as I start to work in PT.
I also have my first PT appointment tomorrow and am lucky to be working with my friend Lee, who knew me prior to surgery and is also an avid triathlete. I hope we do some work with my crutches; right now, I am guarding my left leg, and my hip is paying the price. I have been working on placing my foot on the floor when I stand to brush my teeth or wash my hands, but my leg is unnaturally straight. Hopefully I will get some flexibility back in my calf as I start to work in PT.
Sunday, April 11, 2010
Left Foot, Right Foot Breathe (Days 3 and 4)
Runners must be some of the worst post-op patients ever. I've only been down since Wednesday, but I am completely stir crazy right now. The good thing is that I'm too exhausted to even think about pushing it. A simple walk to the end of the driveway or trip to the bathroom takes all of my energy. It's hard to believe that a week ago, two hour runs were nothing. It's also hard to fathom that I will ever be back to that level of running again. I am hopeful, however, that starting PT on Tuesday will improve my mood.
Since I am only using Tylenol and ice right now to manage pain, pain remains an issue. Once I get settled in a seated or prone position, the pain subsides, but changing between positions remains painful. I definitely underestimated how much pain would be involved; after all, I voluntarily run marathons. With the possibility that I may have to do the right leg at some point, I will take a very different approach to surgery. This time, I assumed that I would be able to go back to work tomorrow (Day 5) and to North Carolina for a conference on Thursday (Day 8). Although the conference is still a possibility, I think it is very unlikely I will be able to go to work tomorrow.
My big accomplishments for the day:
Since I am only using Tylenol and ice right now to manage pain, pain remains an issue. Once I get settled in a seated or prone position, the pain subsides, but changing between positions remains painful. I definitely underestimated how much pain would be involved; after all, I voluntarily run marathons. With the possibility that I may have to do the right leg at some point, I will take a very different approach to surgery. This time, I assumed that I would be able to go back to work tomorrow (Day 5) and to North Carolina for a conference on Thursday (Day 8). Although the conference is still a possibility, I think it is very unlikely I will be able to go to work tomorrow.
My big accomplishments for the day:
- Dressed myself, almost in normal clothes.
- Washed my hair, with the help of my sister.
- Two "walks" to the end of my driveway (100 yards).
Saturday, April 10, 2010
Flashback: Compartment Pressure Measurements
Although it was over a year ago that I had this test done, a fellow runner asked for a post on my experience with the pressure test.
The pressure testing, put bluntly, is not a lot of fun. I had anticipated having local anesthetic to help with the pain, but we started the test about 10 minutes after my run, so I did it with full feeling. The anterior and lateral compartments were not too bad - probably slightly more painful than a shot. The posterior compartments, of which there are two, were very painful. Essentially, they have to push through the first compartment to measure the second. Overall, I would give the procedure a 4 to 6 on the pain scale. The pain is bad, but fleeting. Besides some tenderness around the injection site, I had hardly any discomfort post-test.
One of the biggest benefits for me was the immediacy of the results. While an MRI has to be read, the pressure tests can be evaluated immediately. Although I would end up waiting a year for the surgery, having an accurate picture of what was going on in my calf was great.
The pressure testing, put bluntly, is not a lot of fun. I had anticipated having local anesthetic to help with the pain, but we started the test about 10 minutes after my run, so I did it with full feeling. The anterior and lateral compartments were not too bad - probably slightly more painful than a shot. The posterior compartments, of which there are two, were very painful. Essentially, they have to push through the first compartment to measure the second. Overall, I would give the procedure a 4 to 6 on the pain scale. The pain is bad, but fleeting. Besides some tenderness around the injection site, I had hardly any discomfort post-test.
One of the biggest benefits for me was the immediacy of the results. While an MRI has to be read, the pressure tests can be evaluated immediately. Although I would end up waiting a year for the surgery, having an accurate picture of what was going on in my calf was great.
Recap of Day 2
Yesterday was not a great day for me. I woke up in the middle of the night violently ill and vomited for the next 6 hours. As I've stated previously, pain pills and my stomach do not work well together. That combined with the motion sensor patch wearing off and laying down all day with a stomach full of food made for a very rough night. Ended up with a prescription for anti-nausea pills, which helped me get through yesterday by sleeping 22 of the 24 hours.
I feel much better today; pain is pretty bad, but that's because I'm only using Tylenol and ice to manage pain. The compression and ice wrap is really helpful. I'm very ready to see my scars on Tuesday and to have my pain go down to a 2 or a 3, especially when I'm up on crutches.
I feel much better today; pain is pretty bad, but that's because I'm only using Tylenol and ice to manage pain. The compression and ice wrap is really helpful. I'm very ready to see my scars on Tuesday and to have my pain go down to a 2 or a 3, especially when I'm up on crutches.
Thursday, April 8, 2010
The Day After and Surgery Recap
24 hours ago, I was having a IV started and had gowned up for surgery. Because a couple complicated surgeries preceded mine, I didn't actually meet with the Surgeons or Anesthesiologist until about 1. From there, things got rolling quickly. I was rolled into the OR (which was a beautiful facility, but of course sterile and cold). The last thing I remember was the Anesthesiologist saying "Now, for the real anti-biotics."
While the surgery was successful, the post-op piece quickly became a problem. They informed my mom and Matt at about 1 30 that they could see me in 20 minutes. They then had to wait 2 hours to see me. I was struggling to wake up and in immense pain. Dr. Slauterbeck found a considerable amount of scar tissue in my left leg, which led to more pain than expected. My pain level hovered at an 8 for a long time as they layered pain med upon pain med to try to get me comfortable. The large number of painkillers combined with a bad reaction to anesthesia made me ill, and I didn't get to leave the hospital until after 7 pm. Once I got home and settled, things improved quickly. I was able to eat and rehydrate. I even slept comfortably through the night, save for one pain med wakeup at about 3.
This morning, I feel remarkably well. My pain is at a very comfortable 2 to 3 and seems to be holding there with some good pain management. The Kryocuff I have on, providing pressure and cold, is also helping with comfort. Still, I cannot imagine having two legs done. Although there is a possibility I would have to do this again for the right, I am really hopeful that better attention to flexibility will keep my right leg healthy (and get my left leg back to health).
Time will tell how the whole recovery goes, but for me, the trajectory today has been mercifully downward.
While the surgery was successful, the post-op piece quickly became a problem. They informed my mom and Matt at about 1 30 that they could see me in 20 minutes. They then had to wait 2 hours to see me. I was struggling to wake up and in immense pain. Dr. Slauterbeck found a considerable amount of scar tissue in my left leg, which led to more pain than expected. My pain level hovered at an 8 for a long time as they layered pain med upon pain med to try to get me comfortable. The large number of painkillers combined with a bad reaction to anesthesia made me ill, and I didn't get to leave the hospital until after 7 pm. Once I got home and settled, things improved quickly. I was able to eat and rehydrate. I even slept comfortably through the night, save for one pain med wakeup at about 3.
This morning, I feel remarkably well. My pain is at a very comfortable 2 to 3 and seems to be holding there with some good pain management. The Kryocuff I have on, providing pressure and cold, is also helping with comfort. Still, I cannot imagine having two legs done. Although there is a possibility I would have to do this again for the right, I am really hopeful that better attention to flexibility will keep my right leg healthy (and get my left leg back to health).
Wednesday, April 7, 2010
Day Of Surgery
What a long day for me...finally home and resting comfortably. Will write more tomorrow, but it was not a fun day for me or my loved ones. Pain was at a 9 when I first woke up and stubbornly stayed that high until long into this afternoon, at which point the nausea became insufferable.
Amazing surgical team at Fletcher Allen, from start to finish, especially the nurse and anesthesiologist who stayed far longer than their shift to get me safe and comfortable.
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Amazing surgical team at Fletcher Allen, from start to finish, especially the nurse and anesthesiologist who stayed far longer than their shift to get me safe and comfortable.
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Before (4/7/10)
In just a couple hours, I'll be heading into surgery, so I thought I'd post what my leg used to look like.
Some before stats:
-At rest, pain between a 2 and 3.
-While running, pain at a 7 to 8 within minutes of running
-Marathon PR: 3:15
-Miles Per Week around 55 recently, 60 to 70 pre-injury
Goals:
-Run painfree (eventually)
-Drop Half Marathon down to 1:25 this fall
-Drop Full down to 3:05 late fall
-Get back up to MPW between 60 and 70
Some before stats:
-At rest, pain between a 2 and 3.
-While running, pain at a 7 to 8 within minutes of running
-Marathon PR: 3:15
-Miles Per Week around 55 recently, 60 to 70 pre-injury
Goals:
-Run painfree (eventually)
-Drop Half Marathon down to 1:25 this fall
-Drop Full down to 3:05 late fall
-Get back up to MPW between 60 and 70
Tuesday, April 6, 2010
Where You Sit Depends on Where You Stand
The quip above comes from Miles' Law, commonly used in political science and public policy to describe how each person might view the same policy or principle differently. In my opinion, it is one of the most critical considerations both in public policy, and in life.
In preparing for tomorrow's surgery, I've had one of those moments where you realize how easy your particular seat has been. At first, I was worried about the stairs in my apartment, which head upwards at a pitch barely navigable on two good legs (Example: The 5th tread is 2 inches short). This challenge is easily resolved; I packed a bag and am heading for my parent's house to recover. Still, I am grateful for my family and friends, who are willing to have my crutched and dazed self into their homes.
Wandering around the grocery store last night, however, it occurred to me that the stairs in my apartment were just the beginning of things I will need help with. Managing a cart on crutches will be impossible. As will climbing over the side of a bathtub or using the toilet. My independence is temporarily gone, as I cannot drive or ride the bus. At work, I run up and down the hospital stairs all day long because the elevators are painfully slow. Again, I am lucky to have a network of wonderful people who are going to take care of me over the next few weeks.
I share all of this not to elicit sympathy, as my situation is temporary, but because it made me think about the members of our communities who face mobility challenges every day. The world is just not set up for people with ambulatory restrictions. Sure, we provide wheelchairs in the grocery stores, but even so, the majority of goods are out of reach.
As I head into surgery tomorrow morning, I will be nervous. By tomorrow afternoon, I will be in some pain and at some point during recovery, I will begin to complain. However, I hope that my temporary new perspective not only puts my complaining in check, but that is also yields a long term appreciation for some of the challenges people face in everyday life.
In preparing for tomorrow's surgery, I've had one of those moments where you realize how easy your particular seat has been. At first, I was worried about the stairs in my apartment, which head upwards at a pitch barely navigable on two good legs (Example: The 5th tread is 2 inches short). This challenge is easily resolved; I packed a bag and am heading for my parent's house to recover. Still, I am grateful for my family and friends, who are willing to have my crutched and dazed self into their homes.
Wandering around the grocery store last night, however, it occurred to me that the stairs in my apartment were just the beginning of things I will need help with. Managing a cart on crutches will be impossible. As will climbing over the side of a bathtub or using the toilet. My independence is temporarily gone, as I cannot drive or ride the bus. At work, I run up and down the hospital stairs all day long because the elevators are painfully slow. Again, I am lucky to have a network of wonderful people who are going to take care of me over the next few weeks.
I share all of this not to elicit sympathy, as my situation is temporary, but because it made me think about the members of our communities who face mobility challenges every day. The world is just not set up for people with ambulatory restrictions. Sure, we provide wheelchairs in the grocery stores, but even so, the majority of goods are out of reach.
As I head into surgery tomorrow morning, I will be nervous. By tomorrow afternoon, I will be in some pain and at some point during recovery, I will begin to complain. However, I hope that my temporary new perspective not only puts my complaining in check, but that is also yields a long term appreciation for some of the challenges people face in everyday life.
Saturday, April 3, 2010
The Nitty Gritty
Typically, CECS develops bi-laterally (in both legs), but in my instance, my right leg is asymptomatic. Although my surgeon generally does all four compartments on both legs, we made the decision to only operate on one leg. This is not an easy decision for me and I am still waffling on whether it is the right call. On one hand, if my right leg is fine, surgery introduces unnecessary risk. However, if I develop symptoms in my right leg, an additional surgery means another 6 month break. Given the general risk of surgery and anesthesia, I think I've made the right call.
On Wednesday, Dr. Slauterbeck will make two 10 cm incisions on my left calf. One will be on the lateral aspect of the calf, about halfway between my knee and ankle. A second will be on the medial aspect, where the meat of the calf is. In this incision, he will cut deep to remove the muscle from the bone. Each of these incisions will be used to cut open the fascia and give my compartments some breathing room. Fascia are a spider-web like material that serve to contain muscles and are a vital part of the function of the muscle. Because of their delicate makeup, however, they can also become problematic. People who suffer from PF can certainly attest to this.
All told, this is a relatively simple procedure. I'm doing spinal anesthesia, which means I will be numb from the waist down. This is far less risky than general and a great option for this type of procedure. For me, the hardest part is likely to be the pain medications, which I don't tolerate well at all. After my wisdom teeth were removed, I didn't even fill the prescription because Vicodin upsets my stomach. In this case, however, I think I am going to need the pain meds for at least a few days. Any suggestions for tolerating these meds are welcomed.
After the surgery, I will be on crutches for about a week, then on low activity for an additional week. I can swim at 2 weeks (assuming my scars are healing properly), bike at 4 weeks and begin running again at 6 weeks. I am also lucky to have a friend as my Physical Therapist who is also a runner. I trust him to push me when I need a push and to be conservative when we need to be conservative. I am hopeful that by mid-June, I will be back to moderate running and be able to look towards the fall and an October half-marathon.
On Wednesday, Dr. Slauterbeck will make two 10 cm incisions on my left calf. One will be on the lateral aspect of the calf, about halfway between my knee and ankle. A second will be on the medial aspect, where the meat of the calf is. In this incision, he will cut deep to remove the muscle from the bone. Each of these incisions will be used to cut open the fascia and give my compartments some breathing room. Fascia are a spider-web like material that serve to contain muscles and are a vital part of the function of the muscle. Because of their delicate makeup, however, they can also become problematic. People who suffer from PF can certainly attest to this.
All told, this is a relatively simple procedure. I'm doing spinal anesthesia, which means I will be numb from the waist down. This is far less risky than general and a great option for this type of procedure. For me, the hardest part is likely to be the pain medications, which I don't tolerate well at all. After my wisdom teeth were removed, I didn't even fill the prescription because Vicodin upsets my stomach. In this case, however, I think I am going to need the pain meds for at least a few days. Any suggestions for tolerating these meds are welcomed.
After the surgery, I will be on crutches for about a week, then on low activity for an additional week. I can swim at 2 weeks (assuming my scars are healing properly), bike at 4 weeks and begin running again at 6 weeks. I am also lucky to have a friend as my Physical Therapist who is also a runner. I trust him to push me when I need a push and to be conservative when we need to be conservative. I am hopeful that by mid-June, I will be back to moderate running and be able to look towards the fall and an October half-marathon.
Friday, April 2, 2010
Starting Over
Anyone who knows me knows that I live to run. I run in the dark of winter, with sleet and snow driving in my face. I run in the heat of summer, when the road looks like it's melting into nothingness. Anyone who knows me well knows that this last year has been incredibly difficult for me, as I've faced my first real career threatening injury. Last year, almost to the day, I began having numbness in my foot, which caused me to trip over things and generally be miserable while running. What was once my escape from everything else became a huge stressor and my race times and attitude reflected that.
I was diagnosed with Chronic Exertional Compartment Syndrome, which means that when I run, pressure builds up in the compartments of my calf and pinches off the peroneal nerve that innervates the foot. Not great news for a runner. Over the past year, I've tried many conservative therapies. Research suggests, however, that surgery is really the only solution for CECS. As my symptoms returned in full force about two months ago, I was resigned to the fact that I would need surgery in the near future. This past week, however, when I was unable to run through the pain, that near future became next Wednesday.
In trying to make this decision, I was incredibly frustrated at the lack of popular or anecdotal literature on this syndrome. It is rare and primarily seen in young women, so that may explain some of the silence - not very many people go through this. However, staring down at surgery made me really want someone else to tell me what they had experienced, how they had found their return to running. I have had blogs before, but always for an academic purpose. This will be my first personal blog. I expect it will become intensely personal as I navigate the days and weeks after having my calf cut open. I don't expect it to be all lighthearted - after all, for me, this is heavy stuff. I do hope, however, that sharing my experience both creates an account for someone else with this injury and helps me to work through the myriad emotions I expect to experience in the next 6 to 8 months.
I look at today as the first day of the rest of my running life. As I write this, it's 80 degrees out and beautiful, but I'm looking at a workout in the gym or the pool. It's hard to watch everyone come out of hibernation and run. I ran all winter with this kind of day in my mind's eye, dragging me through snow drifts and puddles. Now, I'm restricted to walking only. I laugh a bit imagining myself in 6 or so weeks, when I'm cleared to jog again. That first quarter mile is going to feel so luxurious after this. I also laugh at the thought of a 2 mile week, down from 70. Undoubtedly, this is going to be an adjustment. As I said to a running friend today, however, I am hoping to use the down time to really reflect on running. It has always been my therapy and honestly, even if the return from this surgery means my competitive marathoning days are over, to be able to run on a daily basis without pain will be worth it.
I was diagnosed with Chronic Exertional Compartment Syndrome, which means that when I run, pressure builds up in the compartments of my calf and pinches off the peroneal nerve that innervates the foot. Not great news for a runner. Over the past year, I've tried many conservative therapies. Research suggests, however, that surgery is really the only solution for CECS. As my symptoms returned in full force about two months ago, I was resigned to the fact that I would need surgery in the near future. This past week, however, when I was unable to run through the pain, that near future became next Wednesday.
In trying to make this decision, I was incredibly frustrated at the lack of popular or anecdotal literature on this syndrome. It is rare and primarily seen in young women, so that may explain some of the silence - not very many people go through this. However, staring down at surgery made me really want someone else to tell me what they had experienced, how they had found their return to running. I have had blogs before, but always for an academic purpose. This will be my first personal blog. I expect it will become intensely personal as I navigate the days and weeks after having my calf cut open. I don't expect it to be all lighthearted - after all, for me, this is heavy stuff. I do hope, however, that sharing my experience both creates an account for someone else with this injury and helps me to work through the myriad emotions I expect to experience in the next 6 to 8 months.
I look at today as the first day of the rest of my running life. As I write this, it's 80 degrees out and beautiful, but I'm looking at a workout in the gym or the pool. It's hard to watch everyone come out of hibernation and run. I ran all winter with this kind of day in my mind's eye, dragging me through snow drifts and puddles. Now, I'm restricted to walking only. I laugh a bit imagining myself in 6 or so weeks, when I'm cleared to jog again. That first quarter mile is going to feel so luxurious after this. I also laugh at the thought of a 2 mile week, down from 70. Undoubtedly, this is going to be an adjustment. As I said to a running friend today, however, I am hoping to use the down time to really reflect on running. It has always been my therapy and honestly, even if the return from this surgery means my competitive marathoning days are over, to be able to run on a daily basis without pain will be worth it.
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