Sunday, April 17, 2016

20 days post surgery

Spirits are stable and mainly up
So here I sit. All in all, my spirits have been pretty even and generally up. I had my post operation visit with the doctors. They said everything seemed to be healing quite well. In fact, I think that worked against me because where my sutures were in, my body was starting to get pissed off to have to deal with them. I had a small spot that a little abscess formed as a result. We quickly got me on some antibiotics and that seems to be working like a charm.

Ditch the crutches
I was expecting at this appointment that they would tell me to start to introduce weight bearing gradually. Instead, they told me to go ahead a lose the crutches and try to have a go with just the boot! I was a bit shocked cause you come in there thinking not to let the foot touch the ground, and leave there with instructions to suck it up. LOL. Kidding of course but only kind of.

I couldn’t do it that first day, it was too painful on the medial and internal side, but was told that was normal. The fat pad at the bottom of my foot wasn’t ready for the weight bearing either so that took a couple days. I do have two pretty big wedges in my boot and I thought I would introduce a familiar feeling to my foot to help it along. So I grabbed an insert from a pair of running shoes and put that in the boot. It actually worked quite well. Within 2 days I was already doing about 90% walking in the boot.

Walking in the book sucks. It makes my one leg a lot longer than the other so I have to be very careful to not let my knee hyper extend while walking in it. I have heard many people need to follow up ankle surgery with knee surgery for this reason. I really don’t want to do that. So I am trying to just take it slow, and when I want to walk fast I grab the crutches.

The boot is heavy, its hot, and I am so thankful I have been cleared to just not have to sleep with it anymore.

Trying to not be a fat ass.

I have been able to go t strength 4 times already. Garrett has been awesome. We come up with complete circuits where I am basically on my knees the entire time. He has been great though as I can actually say I leave there feeling fully challenged.

This week I was able to actually get on the trainer and spin. I leave the fan off so I can actually sweat a little bit but today I was able to ride for 65 min at an average of 165 watts. I have to have the boot on, and a running shoe on the other foot to make it work. I also lower my seat a bit so my calf isn’t put under a lot of stress. I don’t want it to pull on the tendon repair. It makes your ass incredibly sore sitting on a low saddle without any standing breaks at all.

I’m not really working out for a comeback, at least not yet. I still have not decided how and if I’ll do a comeback to competing yet. I have a unique opportunity I believe right now where I can comeback if I want to, but I don’t HAVE to return to the same level of training for myself. This season basically off creates a natural break point for me to decide what it is I want to do. So I am going to take my time with that. For now, I just like moving and staying in touch with fitness. I know I always want to do something.

PT makes all the difference

I have been really lucky to know some of the best PT’s in the world I believe. Three immediately come to mind.

Bryan Hill in California

Wolfgang in Scottsdale

And Gina Pongetti here at home.

Gina works with USA gymnastics athletes, Cirque, and is an Ironman competitor herself. She teaches dry needling, Garston, ART, and many more techniques I’m sure I am leaving out. So I am damn lucky to be able to go to her.  She has been working her magic on it already. We are able to already mobilize the joint, work on the plantar fascia and start to do band work to strengthen my ankle.
It is giving me tremendous confidence that all will be well.

Sick - ugh

I final caught a bit of a cold. So if I can just shake this, I think I’ll be good to go. My next surgery is in 4 weeks. The Dr. was like “you sure?”. I told him, I just want to get through this. If I can be healing two things at once, I’m down for that. I have no doubt that I will be in for a tough May/June. However, my goal is to be able to walk around the 4th of July and be able to work out that morning ding something. 

Sunday, April 10, 2016

2 weeks after surgery

I was able to go off the pain meds after about 3 days. They gave me some powerful stuff, and some not so powerful stuff. I never used the big boy stuff, had a few restless nights but all in all seem to be fine.

My foot swells a bit when I am up and about a lot. That makes it uncomfortable but the stiches seem to be healing quite nicely and Tanya, is dying to take them out here at home. To be fair she is an Orthopedic surgical PA. We are waiting at this point to hear if the Dr. would rather us come in for that.

Gina has given me a few PT sessions already. I’ve been in a boot so have been able to do some slight movements of the foot and its remarkably tight, but very little pain. At this point I think the PRP felt worse for the first week but the IDEA of what is actually trying to heal makes this recovery more serious by far.

I’m supposed to be able to do slight weight bearing starting Tuesday I guess. For the first time since the surgery I can start to wrap my head around the idea that it would actually be able to be done. I worry how this foot will be able to do all that my good foot has been doing for me in just a few short weeks when I have my other one done. I don’t think it will be able to yet but I still would rather they both heal up simultaneously then to get all the way through this then restart the entire process. We may look into wheel chairs for a couple weeks to help ease the burden of the good foot while it gets strong.

I’ve actually been able to work out with Garrett twice. I’m on my knees the entire time but am able to do sit ups, curls, pushups, band work, etc.

I still put the oils on it 2-3 times a day and I think it is helping things heal up nicely.

I should have more to report in a week when I can actually start to use it. until now, it’s just been hanging off my body. So nothing really to update.

I do feel very satisfied at this point I had this done. I have zero regrets. At least for now. J

Friday, April 1, 2016

3 days post Opt

Once I decided to have the surgery I needed to figure out where and when and who.
Dr. Paul Bishop as an amazing podiatrist who I have been using and I initially scheduled my surgery with him and felt very good about the decision. As Paul and I are such good friends, he refused to do my surgery if I didn’t talk to someone else for a second opinion first. He had a few names he wanted me to go see. I really didn’t want to, I wanted to get on with the procedure. Everyone I respected though Paul, Gina, Tanya, etc. told me to get take the time to get the second opinion.

First I cannot believe the level of support that the endurance community gave me. Julie Dibens found out what I was going through and wrote me. She offered to give me her surgeon’s name. Lindsay Corbin said she would help get me in touch with someone.  I can’t thank everyone enough.

I’m the type of person that when I decide to do something, I just want to put the best people around me and get on with the jo at hand. I finally agreed to go to another person though. Paul told me to go see someone he said if he was having it done, this is who he would use. After meeting with this doctor he said I absolutely need surgery on both sides. He is very good at this, has done several hundred, and he had a technique that he felt would allow him to hopefully not have to graft it. It is called a speed bridge. My understanding is it will help increase recovery time. 

I should add here; these are the question I really wanted answered:

-        How hard is this procedure? How important is the person doing it? Obviously you want a good person but was I searching for a brain surgeon type case, or having my tonsils taken out effectively.

A: It’s a pretty important procedure and the skill level of the surgeon matters a lot. Not only in their technique, but their understanding of what you want to do with your life. For example, if you need a graft; if too much of the tendon is damaged they will need to fill that void with something after they cut it out. If they do a graft, there are several options on what they use. Synthetic, hamstring tendon, or mist common is the HFL, which is a tendon that your big toe uses. I did NOT want to use that tendon. The Dr. I went with does use that often, but we agreed to leave that option off the table. You need to know the person has had a lot of success because the scar tissue left behind could then be an issue, or if the tendon isn’t reassembled at the right tension, that could be an issue. So bottom line. The surgeon and his technique matters. Big time.

Do your research on your doctor. It’s insane what I found online. In some forums doctors were asking other for advice on HOW TO DO The surgery. Don’t pick that one. LOL

-        What was my most probable outcome? What would my recovery outlook be?

A: I had a couple people I talked to initially tell me that my career as an elite racer would be over. The surgeons I narrowed it down to felt that while there would be a LONG recovery. Perhaps a year or more, I could have a great chance to return to normal. Nobody could promise me this of course, but I knew I wasn’t going with anyone who going in, didn’t think that was an option. I have to get BOTH done So my recovery will be a bit longer. They wanted to do them 4 months apart. I got him to let me schedule 6 weeks apart.

He wanted me to make sure I was happy with the outcome of this first one, but I already know I hate how my foot feels now so I want to get on with it.

I am told I will be total non-weight bearing for 2-3 weeks. I cannot do any workouts until my sutures heal. Otherwise I risk infection and that’s just simply not worth it. I will start PT next week. This is because I have an amazing PT staff around me. They really know their stuff. You don’t want to activate the tendon but there are other thigs they can do.

I believe your PT the rehab I do will dictate my success at returning to good form. I read stories where some surgeons recommended no PT for follow up and then these people wonder why they haven’t had success with the procedure.

One thing my PT already told me – I need to be able to do 5 single leg calf raises BEFORE I am cleared to really run or the muscles and tendons are not strong enough and while yes I COULD run, it would start laying bone down again because the body has a memory and if it senses that your tendon is not strong enough yet, or the muscles, it will lay down bone again to protect itself.  When you think about that, I am not sure if I could do 5 full calf raises before. Just more proof on the types of “little things” we can all pay attention to get better and make sure we are healthy.

-        How extensive will the surgery be?

A: You don’t get that answer definitively until they get in there and look around. Be prepared for that. You can absolutely get some ideas from an MRI and X-ray but you will not know for sure.

-        How do you know if surgery is the right choice?

A: I tried everything else. PRP, Shock Wave, orthotics, PT, etc. It got to the point that I could run some days with little pain, but then couldn’t walk right the next morning. Or even later that day. For me the pain was bad enough that I was starting to hate training. I wasn’t able to train the way I wanted to in order to be able to do the results I wanted. Then I started to feel terrible just in my everyday life. If I can’t return to the results I used to get, I’ll be bummed, but I can live with that. I don’t want to have pain all day every day like I had been having. That’s when I knew. It just was not fun anymore.

I also wanted to do it at a point it wasn’t so bad that my body couldn’t come back from it. I wanted to be decisive as to give myself the highest probability of success for recovery

So I had surgery on March 29th, 2016.  They did a local nerve block which meant I couldn’t feel my leg and general anesthesia. I had never had this before and I can’t believe how out you are for a surgery. I have to admit it’s one of the craziest things I’ve ever experienced.  

The surgeon said he has done several hundreds of these and I was in the top 3 overall with the extent of the of the bone growth. He was worried that the growth was so bad that the bone would no longer bleed. Essentially your body gives up on the area. He said mine bled very well, the blood looked very healthy and the surrounding Achilles tissue was in good shape! I credit that to the therapy I have been getting and Tanya having me on her essential oil supplements.

The last two days I have been pretty uncomfortable, been managing with pain meds. My foot cramped in the middle of the night on the second night home which made me shriek in pain. I was upset because I thought it hurt, but was afraid I was going to mess up the healing. I was wearing my boot and as long as you do what you are told and wear it, you should be fine.

Tanya has given me all type of oils to apply to the surrounding area (not the incision). They help promote tissue growth, anti-inflammatory, and immune health. I know the two things I want to try to prevent now are infections and scar tissue. So I am doing everything I can think of to do that.

I’m still not ready to go for a run yet, or really anything else, but it is feeling a lot better already on day 3.