Surgery notes and 48 hours later

Morning of Surgery

On Thursday, August 9, my cousin, dad and I loaded up my car and embarked on the hour-long trip down to Fort Collins, CO, for my arthroscopy procedure. My cousin had been in town visiting for several days and was on her way to Denver. My dad came all the way from Florida to gladly be my nurse for the next week.

We left Laramie at 6:30 am. I had to be at my appointment at 8:00 am, and surgery was scheduled for 9:30. Much to my surprise, I wasn’t particularly anxious. Just thirsty. I had been allowed to eat solid food up until 11:00 pm the night before, and clear liquids until 5:30 am that morning, but I hadn’t actually had anything to drink since I woke up.

My surgery was scheduled with Dr. Houghton at the Orthopaedic and Spine Center of the Rockies in Fort Collins. Both he and another surgeon in Laramie had reviewed my MRI and provided the same diagnosis and treatment options. My insurance better covered the procedure in Colorado, which is why I traveled.

I was called back to the pre-op ward shortly after we arrived. I changed into my surgery gown and a hair cap, and had my earrings taped. Then I was put up in a bed to wait for my procedure and was administered an IV. My dad and cousin were then allowed to wait with me, which eased my anxiety and passed the time. At this point, I was mostly hungry. The nurse offered a relaxer drip and I gladly took it — “It’s gonna feel a little bit like you just had a couple margaritas.” It helped quiet the anxiety in my mind and stopped my extremities from shaking.

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I do like a good margarita or two

The doc was running a little behind schedule, so 9:30 came and went before he briefly appeared to initial my operative leg. It was around 10:15 am when the nurses collected me. I left behind my glasses and waved goodbye to my crew. The margaritas had worn off, but I was ok. At that point, you know you’re in good hands and that you’ll be unconscious in a minute anyway.

It was a short and blurry trip to the OR, my only impression of which was that the lighting was excessively bright. In about two minutes, I was moved onto the operating table as an assembly of people I couldn’t make out repositioned me, placed a gas mask over my face, and told me the anesthesia was coming. I could hear the beeping as my heart rate shot up, but the slow fade was right there waiting for me.

I woke up with that groggy confusion where you know vaguely what’s going on, but you feel like you’ve been asleep for years. I immediately asked what time it was, and wondered whether the surgery had happened yet. It was about 11:30 am. The nurse asked me how I was feeling, and I blurted out that I’d really like a bagel.

She helped me change back into my clothes and wheeled me out to meet my dad in the ward. She gave me a pain pill and briefed him on the next steps. I was still a bit too groggy to follow along. Eventually, my dad went to retrieve the car, and the nurse wheeled me outside. I remember smiling as I left, and feeling an easy, blissful happiness.

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Tip #1: wear a skirt and pack extra pillows.

24 Hours Post-Op

Once we got home, I spent the afternoon on the couch feeling very satisfied with the whole day. At the surgery center, I was provided a small walking shoe to wear with my surgery dressings and a pair of crutches. No boot! The wrapping and bandages will come off on Monday, four days post-op.

I was in very little pain and great spirits upon arriving home, which had nothing to do with drugs. For the first 24 hours, I took a pain reliever every four hours, and now I’m just taking it as needed. My foot was almost entirely numb until about 3:00 pm the next day, and when that wore off I could finally feel a dull aching sensation near the incision.

The surgery nurse instructed me to keep my leg elevated and do ankle circles and “calf pumps” as needed. I don’t have much range of motion due to the bandages, but I’ve been keeping pretty limber. I’ve also been doing calf massage manually or with a stick.

My throat was pretty sore from the anesthesia, but drinking water and echinacea tea helped with that. The first morning after surgery I opted for green tea instead of my usual decaf coffee, and my dad crafted a green smoothie for me to have with breakfast, using kale and mint from my yard.

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Tip #2: bring a buddy

48 Hours Post-Op

I am not one to enjoy mandatory bed rest, so the last 48 hours have slowly gotten boring once the novelty wore off. Lots of reading, naps, and endless scrolling. Sleeping has been relatively easy once my nighttime anxiety about blood clots settles down.

The hardest activity by far has been bathing. I might not try it again for a minute. It was mild chaos — just, like, flailing around while keeping one foot above water in a plastic bag. And I have pretty good balance, but that’s a lot of faith to put in my right leg while maneuvering out of slippery porcelain. Ya know, hygiene is overrated anyway.

To recover from something like this requires a sound nutrition plan. I’ve been eating well and with intention. Lots of veggies, grains, and protein. I know the prospect of immobilization scares a lot of neurotic runners, but you have to respect what your body is going through, and retaining your runner physique is far less urgent than repairing the injury completely. Now is not the time to pass judgment. There’s not much you can do about being restricted from bipedal movement; don’t make things harder by restricting your diet as well.

I don’t know how long the non-weight bearing phase will last. Could be 2 weeks, could be 6. The shoe makes me optimistic that it’ll be on the shorter end. I am ok with not knowing. I am ok with trusting the process. I am ok with the temporary loss of physical activity if it means I can have it all back eventually. Embracing the unknown is hard, but remaining positive that your patience will pay off is the only way to see this stuff through, in my experience.

Do you have advice or tips to share?

Ankle injury diagnosis

Osteochondral lesion of the talus

I’ve been injured for a long time. For months. Actually, for the better part of a year. With no signs of improvement or relief. No timetable for a return to running. I’m inclined to share the entire months-long progression, but that’s not really useful to anyone. After exhausting all other options, I finally did what I should’ve done weeks ago and got an MRI.

Osteochondral lesion of the talus. There is a fracture in the cartilage that sits at the top of the talus bone in my left ankle, and the underlying bone has been damaged considerably. I remembered thinking once, “ok, it’s gotta be either a stress fracture or arthritis.” I wasn’t far off. And I was closer than most professionals had come.

An OLT is a tricky injury, I’ve now learned. Cartilage isn’t known for its ability to repair itself or regrow, and the talus is a very low-blood-flow area. A scope surgery is one of the only ways to treat this injury successfully. This procedure allows for cleaning debris from the injured area and drilling into the talus to create a microfracture. Ideally, this chain of events encourages new bone to grow and scar tissue will fill in for the cartilage.

That is the surgery I am now scheduled to have next month. That is the part I want to share. I spent months Googling my symptoms, trying to find a home for my injury, only to find very little reliable information and misdiagnose myself repeatedly.

I’m a runner. I’ve had all the “traditional” soft tissue injuries and a metatarsal fracture, too. But this is a new one for me, and the most difficult one for sure, especially when it’s been years since my last major injury. For weeks I wished it was a stress fracture – so straightforward! Almost guaranteed to run again in 8-12 weeks. Currently, I’m so far away from my usual place of fitness that going into surgery at this point is like “well, what’s another 6 weeks.” But at least I have a time frame, finally.

In the meantime, I’ll be updating throughout my pre-op phase, and then detailing the surgery and recovery plan. I struggled to find the information I needed, so I hope I may be a resource for someone else.

Predominate symptoms I experienced over the last 8 months:

  • A crunching, grinding, catching sensation inside the ankle joint
  • Shooting pain or a compressive ache in the ankle while ascending stairs or pedaling a bike
  • Midfoot instability
  • Sharp pain at the front of the ankle that was confused with both a cuboid fracture and impingement syndrome
  • Skin numbness across the bridge of the ankle, where you tie your laces, and behind the ankle on the lateral side
  • Joint pain in the medial arch of my foot
  • Swelling near the peroneal tendons
  • Pain and pinching behind the ankle on the medial side

Because of these symptoms, various physical therapists and doctors diagnosed me with a wide range of afflictions from plantar fasciitis to cuboid subluxation to tarsal tunnel syndrome – and keep in mind, none of these even occur in the same part of the ankle. That’s how much the pain migrated. I was able to run with it for about four months, and finally started to feel like the whole ankle was about to shatter, at which point I stopped.

Conservative treatments I tried:

  • Rest. Like, days, then weeks, then months of rest
  • Cross-training on the elliptical or bike
  • Dry needling, laser therapy, manual therapy, ice massage, NSAIDS
  • Air cast walking boot
  • Running? We all think maybe it’ll just “clear up”

Osteochondral lesion of the talus. I went to 4 physical therapists over this time. That’s maybe the most frustrating part. Every misdiagnosis made me feel like I wasn’t being heard. Like everyone was confirming their own biases instead of listening when I repeatedly said SOMETHING HURTS INSIDE THE ANKLE. It’s not the fucking plantar fascia! I often wish I had gotten imaging earlier. Thinking how much time I wasted beating myself up over useless rehab exercises, wondering what I was doing wrong… Knowing somewhere in my heart that it would lead to this. That it had to.

But I can’t dwell on that. That chapter is behind me. When I left the consultation with my physical therapist after he’d received my MRI results, I said, “You know, I actually feel excited. Relieved. A little scared. The hard part is over, and I see a light at the end of the tunnel.”

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If you have experience with this or another similarly drawn-out injury, please reach out! Constructive, supportive feedback is something you can’t find over at the LRC message boards.