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.
https://vimeo.com/92840257 

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. 

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