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.

4 comments:

  1. Hi Sarah -

    Just stumbled across this, thanks for writing about your experience. I'm a sub-10 hour Ironman guy who's been ground to a halt for about 6 months, so I can totally relate to this. For me, everything bothers it - swimming, cycling, pushing a gas pedal. What I thought was an Achilles issue (among a bunch of calf stuff that the docs kept shugging off) not is clearly much more and I'm working on getting a pressure test scheduled.

    I'm hoping it's positive, and if so I'll be following your path as soon as they can get me on the table and I can find the right doc.

    In any case, I can't wait to read that you're running again.

    Keep bloggin.

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  2. Sarah I am sorry about your complications! I just had my pressure test this morning on both legs and I had very high, positive, readings in my anterior and lateral compartments in my left leg. My right is borderline and I will likely take a conservative approach.
    Something to consider about your statements about giving up running rather than have surgery again: I stopped running 6 weeks ago when I started have numbness and foot drop. I still have pressure feelings daily from cross training. I do spinning a few times a week and elliptical as well as lower body weights and lunges, etc. The cycling has caused the same symptoms though not as dramatically/painfully.
    I can't bear the thought of giving up all exercise so for me it's an easy choice.

    I hope you continue to heal well. Best wishes.

    Jenn

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  3. @Shawn: Good luck on your journey - we'll be back out there soon enough. Keep me posted on how your experience goes.

    @Jenn: I had numbness with cycling, but not elliptical. I do hear you on exercise being integral to a happy life! Last year, when I took the conservative route, cutting mileage down worked for me. I am hopeful that this surgery will be a success, but for me, if faced with the choice between another surgery and alternate outlets for fitness, I would be very reticent to choose surgery again.

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  4. I'm in the same boat as Jenn. I can't do anything, really, including more than a couple of days of lots of walking. Riding more than 45 minutes on the trainer gets uncomfortable and riding outside is out of the question. Just kicking too much in the pool will give me tightness and ache in my calf.

    So, if CECS is in fact what's going on with me, my choice is basically surgery or sedentary. And for someone who's been doing 15-20 hour training weeks 40+ weeks a year since 2006, that's a major life impact itself, nevermind the social network that I've built around the sport that now is difficult for me to interact with. I don't mean to be glib, but at this point I can't think of any amount of discomfort that I wouldn't sign up for to get my active life back. Maybe that's naive.

    I like that you're being honest with your feelings on this Sarah, and DVT is nothing to screw around with. Still, I am wondering how you'll feel in a few weeks when you start to turn the corner on this thing (it sounds like the 4w mark is when the suck starts to really diminish for people), or how you'll feel when you go run pain free then bank that 3:05 marathon in the next 12 months.

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