2 Months Post-op

Not much to discuss anymore, which is probably a good thing. Last week I was able to liberate myself from the boot, likely forever, and I started taking the stairs again (!), so things are feeling much better. At PT I learned that the swelling looked minimal, and that having my incisions massaged is a special kind of torture. By the way, last week marked two months since surgery!

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Two months later and it’s 35-degrees out. Definitely not August anymore.

I made some other advancements at PT, too, like re-introducing standing leg exercises. I did some leg presses on the reclining slide board, as well as theraband walks, single leg step downs, and balances on one leg. These are all welcome additions to my now-very-stale mat routine. During single leg balances, I impressed my PT (as well as myself) by making a spectacular save for a ball that rebounded poorly, and I chalked it all up to many years of stability training in the bank. Let’s hope my aerobic memory proves just as good as my muscle memory.

I also spent some time with the blood flow resistance cuffs, so I can explain that a little more now. It’s exactly what it sounds like — a blood pressure cuff from hell. They slide all the way up the thigh, and then my PT pumps up the cuffs while monitoring a pulse in my leg, and sets the pressure near 70% restriction. It’s not exactly a comfortable experience. I imagine it’s what being killed by a boa constrictor feels like. And it makes it super hard to use your legs.

The science is that by cutting off venous return (and some arterial flow), essentially depriving the tissues of oxygen, the cuffs simulate the work of an anaerobic or a lactic session without literally doing the work. So when the cuffs are on, we do leg presses or hip bridges basically to exhaustion, which doesn’t take as long as you’d think. It’s fucking hard. Plus, you stimulate production of anaerobic enzymes and it supposedly offers a great aerobic benefit by just walking around.

On Friday I suffered for 8 minutes on the treadmill at 1.7 MPH and felt like I’d run a tempo. Not like I was physically stressed or breathing hard, but my legs were like lead after that. It’s definitely weird. You can feel every muscle contracting. PT said he had someone get light headed with them recently, and yeah I could see that, especially if you’re not well-trained or accustomed to the feeling of exertion. The first time they made me anxious, but I’m more relaxed about them now.

Last week I worked on extending time spent in the pool and on the bike, and finally added a couple turns of resistance to the spin bike by the end of the week. I have started making pool friends too! A pair of students comes several times a week accompanying a very old man named Pablo while he swims laps, so we occasionally spend a lap or two chatting as we tread past each other.

Here’s the workouts from last week:

  • MON: 20 min cycle w/ zero resistance, 20 min aqua jog, core + lift
  • TUES: PT, 30 min aqua jog
  • WEDS: 20 min bike w/ zero resistance, 20 min aqua jog, core
  • THUR: 30 min aqua jog
  • FRI: 30 min cycle w/ some added resistance, core, PT w/ BFR cuffs
  • SAT: Swam 40 laps at the Rec center, about 20 mins of work (it’s a short pool, don’t be too impressed)
  • SUN: Off

A new week is already kicking along, so I’ll have another update in a couple days.

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On our last (maybe so) warm and sunny day, I harvested all my remaining tomatoes and pulled up the stalks. It made me sad, and then it snowed two days later.

 

Look, ma, no crutches!

Now that I’ve rejoined the land of the living for over a whole week, it’s hard to remember ever stumbling around on crutches. I’ve been wearing the boot a lot. I don’t wear it 24/7, but for lengthy bouts on campus or running errands, it has been helpful. Throughout the week there’s been some swelling along with pain near the talus, which I’m sure isn’t unusual after surgery. So staying strapped into the boot during the week alleviates that, and it was starting to feel better this weekend. It’s helpful to ice and elevate (I should follow my own advice and do those things more often), and to get out of the boot for periodically to avoid stiffness.

Here’s a list of the “workouts” I was able to accomplish last week:

  • Mon: 10 min bike w/ zero resistance, lift + core, pool for drills and walking
  • Tues: PT session with BFR cuffs, 15 min aqua jog, core
  • Weds: 20 min bike w/ zero resistance, 15 min aqua jog, core
  • Thurs: 20 min aqua jog, core
  • Fri: 30 min bike w/ zero resistance, lift + core
  • Sat: 30 lap swim + walking and drills in pool
  • Sun: Off

I did a fair amount of gardening this weekend because I think it’s about to start frosting for good, and my weeds were out of control. So I cleaned up beds and dug up the mint that was starting to run across the yard. My tenant’s boyfriend called me a 70-year-old. Okay, well, I’d rather tend to housekeeping priorities that bring joy instead of hiding in bed with a hangover on a Sunday morning, if that’s what you’re implying. Because yeah… I’m definitely too old for that.

Anyway, this first week has been productive without over-doing anything. There is literally no rush, so I’m like hey even if I need to use the boot for the next two weeks, that’s okay. I changed my expectations more than once, but was also surprised a couple times by how easily things were going. For instance, I’m realizing I won’t be ready to attempt yoga for a few more weeks still, but aqua jogging 20 minutes was way more manageable than anticipated, aside from super tired hamstrings.

Happy Monday! Get after it.

“I did abs every day for 6 weeks and here’s what happened!”

Well… if you think any program like that can get you ripped, think again. My pelvic floor may be stronger than ever but otherwise it offered few benefits except a routine. One leg is shriveled and saggy, the other is only slightly stronger. I have zero aerobic capacity to speak of, and I don’t have a six-pack. But, of utmost concern to everyone going through a similar situation, no, I didn’t really gain any weight. My secret is… I ate normally, didn’t drink for about a month, and was in fairly good shape to begin with.

It’s been almost 72 hours since I kissed my crutches good-bye and limped out the door of the Laramie orthopedic center. I have four and a half months until I’ll be running again, so my goal is to provide the inside scoop on how to get from here to there over that time. I’m pretty immersed with school these days, but I should be able to add updates once a week.

And now to answer that burning question: what is it like to walk again?

I almost barfed on my way out from the doctor’s the other day. All the blood that was pooled in my foot went squirting out in a sharp, unpleasant way, like walking on a limb that’s fallen asleep, plus my leg about collapsed. (It really makes me revisit that unsolved mystery from a month ago; I don’t know if adrenaline is powerful enough to overcome the sensation of walking on an unused leg.) Later that day I walked to the end of my street and back, and it took a whopping ten minutes.

My surgeon’s office told me to wear an air cast boot until I feel comfortable walking regularly in a shoe. I had already come to that conclusion on my own and was glad I’d kept the boot stashed under my bed for the last few months. I wear it when I run errands or have to spend prolonged time on my feet. I just get around a little faster with it. But most of the time I’ve been walking barefoot at home, trying to regain full function.

It actually comes back faster than you’d think. By the end of the third day, walking felt almost normal again. Going up and down stairs is the most difficult. And I can’t walk super fast, but it’s much better than day one when I clocked 40 minutes per mile pace on my neighborhood walk and had to take an ibuprofen.

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I don’t really have any photos to add, but look how much my hollyhocks grew while I was sitting around on my ass repairing a joint!

My left calf has been so sore in the mornings it reminds me of college when we could barely make it out of our lofted dorm beds after the first spike day of the track season. I spend a couple minutes in the evenings rolling it on a hard plastic ball to keep the fibers loose. And the first day both my heels were excruciatingly painful by bedtime. Rolling helps with that, too.

I’ll be seeing my PT twice a week for the next four weeks to do “blood flow restriction” training. More on that when I’ve actually witnessed it in person. This week I went in the day after I started walking, and we literally just practiced walking. Which was exhausting and made me feel like a newborn animal. I was still limping heavily at that point, and my PT had me break down the stride cycle by focusing on toe-off and then heel-strike. My muscles were so tired at the end I could barely walk all over again.

This weekend I’ve been visiting the rec center to walk around in the pool. Next week I’ll try aqua jogging on campus, but I’m honestly not quite there yet. For now, I walk back and forth a couple laps, sideways and zig zag, and do leg swings and hip circles. Then I breaststroke a couple lengths (like 10 max — remember when I could do 60?) very slowly. That’s about it and I’m ready for a nap.

I’m still doing my core routines, but now I can add a couple things, like a proper pelvic tilt, bridge, and standing on one leg. I’m not ready for anything resembling yoga, but I got the green light to cycle on zero resistance. No word yet on the elliptical, but realistically I don’t expect to add it until about 10 or 12 weeks post-op.

Let the countdown to running begin! Eighteen weeks to go.

Five weeks post-op

Holy shit. One week left. It’s a bit hard to believe it’s “already” comin’ in hot, but it still can’t get here quickly enough. A guy on campus blew past me on his bike today and told me to watch where I was going. I almost cried. (As if he would’ve won that case had he actually hit me — not a chance, bro.) So yeah. I wouldn’t mind being through with the whole ordeal. Here are all the things I’m gonna do on repeat when I unleash myself to the world again:

  • PULL WEEDS!
  • Swim til I drown
  • Cook dinner for myself for a week straight
  • Brew kombucha
  • Go on a walk
  • Do ANY exercise that isn’t abs
  • Shower standing up
  • Clean my house of ALL evidence of humans and animals alike
  • Go to the bar. Yeah.
  • Relearn how to drive my car
  • Stand exclusively on my left leg for six weeks

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It took about 2 weeks for the scabs to fall off after my stitches came out. Pretty minimal scarring. I’ve had shaving accidents worse than that.

I’m not really sure what to expect at my review next week. I assume I’ll be going in with crutches and leaving without them. I’m seeing the Laramie equivalent of the Fort Collins surgeon who actually performed my surgery. I don’t have the resources or time to travel to Fort Collins during a school week for appointments, so I had all my records released and transferred here.

And then it will be back to PT the next day to commence with the real work of restrengthening and retraining.

In the end, no, I did not attempt to swim and will not until I am walking. Most of the feedback I received from friends and family was to listen to the instructions I was given. Which seemed reasonable. As time passed, I also felt less angsty about the lack of exercise and a month hasn’t felt as long as it seemed initially. I have such a long road ahead before I can run anyway that there is little point in rushing anything, and I think the total rest will pay off.

That being said, I’ve very diligently done core and glute activation exercises every day for the past five weeks. Among other causes, I think lack of functional core strength was a major player in this injury, and I had really been neglecting it last summer when everything presented itself. If only runners could actually be counted on to take care of the small things before disaster strikes. We’d put surgeons and therapists out of business.

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Credit to bodybybodde.com (Google search) for this crude representation of a prone glute raise

As a point of reference, when I first began physical therapy a year ago, I couldn’t perform this somewhat basic glute exercise ^^ that I have now mastered. And it only took about four weeks! ON A LEG I’M NOT EVEN USING! Runners!! Do your damn core work. It’s cheaper than surgery.

Help! I walked on my foot: what to do if an accident occurs?

I am writing this because I couldn’t find the information I was desperately hunting for on the internet. Maybe it will be helpful to someone else. Always call your doctor first in an emergency or if questions arise, but if that option is not available because it is after-hours or the weekend, as was the case for me, sit tight and try to relax. Unless it’s an actual emergency; then you might wanna get that checked out ASAP. How to differentiate is probably up to you.

Saturday morning. 16 days after surgery. I blink my eyes open just before 7:30. My cat is already eyeing me from the nightstand. When she wants breakfast she is quite the attention hog, and being that she is younger than 2 years old, she has lots of energy. I roll over to ignore her for a few more minutes. But she has other plans. On this particular morning, she chooses to get her kicks by attempting to jump into the high windows above my bed (which, I might add, are obscured by curtains and don’t even accommodate her well). She launches from my nightstand, sending a stack of books flying and knocking over a water bottle, my lamp…

Half-asleep Claire is NOT having these shenanigans today. I wrench myself awake, yelling “For fuck’s sake!” as I grab my lamp off the floor, and she goes flying out the bedroom door. I jump out of bed like a rocket, slam the door shut, and throw myself back under the covers.

It took all of 10 seconds. My adrenaline is rushing. Several minutes go by, and slowly I realize…

I don’t think I used my crutches.

I panic. I can’t remember. Do my pits feel freshly chafed? Does my shriveled calf feel strained? No, no, I think I would’ve noticed if I’d landed on my left foot — my leg has zero muscle, it would’ve collapsed — I would’ve noticed! I glance at my crutches. They have slid slightly off my nightstand, as they were right in the books’ line of fire. Doesn’t seem like I would’ve just left them there, like that, though… I do not remember using them. It happened so fast. I think I would remember fumbling to grab them and put them back again… I. Can’t. Remember.

I stayed in bed another 90 minutes crying and debating what to do. Googling anything I could Google. I called my doctor’s office, forgetting it was Saturday morning. Trying to remember. And the more I tried, the less I could recall. The details slipped out of my mind like water. I circled my ankle. Became angry. Upset. Fucking pissed off at myself for what I did. Mad at the cat. But it wasn’t her fault. Why haven’t I been locking her out at night? Why haven’t I been wrapping my foot at night? Why didn’t I give her attention? How did I not think to grab my crutches? Why didn’t I breathe for five seconds before reacting?

And that’s the truth. I didn’t even think. As the adrenaline wore off, I began to notice a faint throbbing, a dull ache. There hadn’t been any pain previously. But now, this ache, and I feel like I know in my heart what happened. I have no evidence to prove that I’m innocent.

I got up to eat. Feed the damn cat. Wrap my foot. Put ice on it. Take ibuprofen. And then I returned to my room, closed the door, and went back to sleep for hours.

* * *

The verdict is that I most likely didn’t cause anything to worry about. I spoke to an aid in my surgeon’s office right away on Monday morning who reassured me. Three or four steps isn’t enough to ruin the surgery. There was never any noticeable swelling or bruising, and the aching subsided to give way to general stiffness. Over 72 hours later, I have fully resumed all my PT and ROM work with no adverse symptoms.

Here’s the thing — accidents happen, and doctors account for that. My feeling is that if they thought it was too big a risk, they could have put me in a cast. They would do more to prevent it than simply mandating compliance. The last time I was on crutches, for a stress fracture, I landed on it a couple times due to losing balance on stairs. The same has happened once or twice this time. It’s to be expected when using crutches.

Disclaimer:

I am not a health professional. If you have an accident that you are unsure of, I would advise getting help immediately. New bruising, swelling, and pain that comes on afterwards might be a sign of trouble. If you fall and twist the joint in question, you deffff might wanna get to the ER. But those little bumps and mishaps — they are bound to happen. Be smart, don’t sweat it, and calm the eff down.