Day 105: 15 weeks + PT Session #19

*15 week surgery anniversary*

I had to break the news of scheduling my second surgery to my therapist.  It wasn't so much of a shock, more of a realization that this is all about to happen again.

We both know that this is the best option for my future...so we carried on strengthening my left to prepare it to be the main support foot while my right goes through surgery and recovery.

Day 104: Right Foot MRI

10:00 am- Right Foot MRI

The whole experience felt a little eerie, because just months prior, I made the same drive to the imaging place and had an MRI done on my left foot.  Filling out the paperwork was interesting because I had to claim that I had surgery and that I had metal in me.  I guess I have a lifetime ahead of me of filling out significant prior medical history now.  I used to easily check no/not applicable for everything.  Oh well...

The MRI didn't take long, but it did zap all of my energy and my will to live that day from me. I wanted to just go home and escape, but instead I had finals to prepare and take.  Pesky school...thank goodness it will be over soon.

5:00 pm- Last in class final...EVER

Day 103: Scar Update

Day 102: Paying the Price

After a full day of activity yesterday and having more time to process the news of having the second surgery scheduled, today was rough both physically and emotionally.

I really don't know if my feet or my brain hurt worse.  There is an old quote that I learned during my college track days, "The heart achieves what the mind believes."  I have stayed really positive and optimistic through the vast majority of my recovery.  I have willed myself to heal faster and make major progress...with my left...but then my right just pulled the rug right up from under me.  No matter how hard I focus my energy on improving and doing what I need to do to be able to walk normally again, my right foot will need the same surgery.

So hard to deal...

More icing, elevating, and drugs.

Day 101: Day of Terror + Wearing Wedges

Morning

I had several errands to run in preparation for a 250+ person banquet that I was leading the production of.  One of the tasks I had to do was pick up some of the supplies that were in heavy boxes.  The sales clerk said thanks, and bye, as if our transaction was over.  My heart sank when I had to tell him that he was going to have to carry the boxes to my car or get someone else to do it for me.  One of the things that I value the most is my independence.  I get a lot of it from keeping myself in a highly trained state that prepares me for handling even the toughest of activities of daily living.  Of course I would rather have doors opened for me, stuff carried for me, stuff around the house fixed for me...but I pride myself in wanting those things instead of needing those things done for me to survive.  I am literally dependent on other people to help me at this point and I absolutely HATE IT!

While I was at the first place, I missed the call I had been waiting for from my doctor's physician assistant (PA).  His message said that he was going to be out of town the whole next week, so I had to talk to him today.  I called him right back but didn't get an answer.  Since the doctor's office was on my way home, I figured that I would stop by to see if I could talk to him briefly.

What a life-changing decision that was...

I ended up talking with the PA in my doctor's office.  Upon detailing the struggles I had been having with my right foot and his inspection of it, he confirmed that my right foot was in trouble.  He told me that it would need surgery, but that I had to decide how frustrated I am with it to determine the timeline.  He also added that since it is a RIGHT foot surgery, that I was going to have to think about placing it on my life timeline more seriously because I will not be able to drive for at a minimum of 2 months.  I further explained how stripped down my activities of daily living are and the difficulties I have been having doing even the simplest of tasks.  I told him that in terms of frustration, I am at the absolute end of my rope.  He paused and then said with a heaviness, "No 25 year old should have to go through this."

I could feel the depth of his sympathy for me when he realized that I was having to go through this...AGAIN.

As the discussion ended, he walked me right over to the surgery scheduler to put my surgery on the calendar.  In a blink of an eye, my second surgery was scheduled for June 4, 2013, exactly 5 months post my left foot surgery.  I also got prescriptions for pre-op blood work, the dreaded return of the wheelchair, and 600 mg ibuprofen and Tylenol 3 to help with my increased pain levels.  He also had me schedule an MRI for this coming Monday.

An innocent trip in to talk to the PA turned into my second surgery fully scheduled.  I just wanted to go home and cry at that point.  Cry I did, but I only made it to my car before the waterworks began.  I didn't have much time to process what had happened because I had my big banquet coming up and had to finish preparing.

---------------------
Afternoon

Swim!  It felt great.  I did a quick 600 m.  I swam as fast as I literally could to try to escape the news that I got this morning.

Final banquet prep.

---------------------

Night

Banquet- It was everything I could have asked for and more.  My team did an awesome job organizing it and everyone had a great time.  The catch- I wore wedges (the conservative pair by Clark's pictured on an earlier post) for the first time since surgery.  Being one of the organizers, and having to give multiple speeches, no way was I going to wear an ugly pair of flats or my tennis shoes with the AMAZING dress I was wearing.  I focused on running the banquet and completely ignored how my feet were feeling.  I even went out after with a few of my friends to reminisce on the night and the year of accomplishments.

When I got home...

...several rounds of icing + drugs + elevation.

Oh the price I have to pay to do "normal" activities.

PT Session #18: Lonely :(

My therapist was off today, so I worked with another therapist.  Going to PT has become such a normal part of my routine.  I spend so much time there that it has started to feel like a version of home for me.

Working with this other therapist made it a foreign experience.  There weren't many therapists or patients there today.  At one point, I looked up and realized that I was the youngest person in the whole building.  I don't know where the high school and college aged kids were today.  The therapist I worked with was obviously qualified and knew what he was doing but I have really come to realize over the last few weeks how important it is to have a "personal" relationship with your therapist.

What I mean is, my therapist has come to know my personality, my individual quirks, and my strengths and weaknesses physically and motivation wise.  He always seems to be more attentive exactly when I need him to be and hands off when I just need to work through a challenging exercise on my own.

This therapist told me my exercises, set up some stations for me, and then was pretty hands off the whole time.  I felt so alone.  Not all of the exercises require complete focus.  So then it was just me standing there stretching my calf, or balancing on my leg, or doing some leg presses.  Therapy is waaaay worse when all you have to think about is how boring and mundane all of the strengthening exercises are.

My left took to all of the exercises well.  My right hasn't bothered me as much since I have completely stripped all of the weight bearing activities out of my life.

Every PT appointment ends with icing.  My feet are so bad off that I have to do GameReady (Ice + Compression) on BOTH FEET.  We have been doing this ever since my right foot collapsed.

100 DAYS!!!

WOW...I have made it 100 days.  I can't believe this.

My left foot feels great and is still way ahead of schedule.  I haven't worn my ankle brace one day this week...just my oh so attractive Brooks Motion Control/Extreme Stability tennis shoes.

My right foot continues to limit all of my activities of daily living.  I am waiting on a call from my doctor on when my MRI and my right ankle reconstruction surgery is scheduled.

I have many more tough days ahead of me...but I am still here, which means there is always time for a comeback.

Day 99: 800m Swim

I returned to the pool for my third swim since the surgery.

It felt absolutely AMAZING.  I always feel so free when I am swimming.

800m:

100m warmup
100m drills
200m- 5:00
2 x 100m- 2:30
2 x 50m- 1:05
100 cooldown

Day 98: 14 weeks + PT Session #17

*14 week surgery anniversary*

It was much easier getting through therapy with my new attitude.  I know that another surgery is inevitable and that I just have to accept it.  I also know that even though it has been almost a year already of feeling pain in one or both feet with every step of every day, that I will have to go through at least another year of that.

Accepting that my life is going to continue to suck for an indeterminate amount of time has made things easier.  I know that my feet are going to hurt, so there is no point thinking about it or wishing that they didn't.

We did a lot of new exercises in therapy.  We spent most of the time talking about marathon running, since I gave my therapist his plan.  Nothing brings me more joy than reminiscing on the best period of my life.

Shoe Purging

I went through my shoe collection...of which I haven't been able to use for a year.  I have spent an entire year in tennis shoes!

I am donating 21 pairs that I know that I will never be able to wear again because they are flat and have no arch or ankle support.

Bye shoes...it was real.

New footwear:

My new wedges with a conservative heel and velcro strap to keep my ankle secure compared to my favorite pair of wedges :(

Compared to my favorite pair of heels :(

I refuse to get rid of any of my heels.  One day...some day...way in the future...I am going to be able to wear those again.

Workout

20 mins hard interval ride- road bike (1:1)

Standing calf stretches

40 bosu squats

40 single leg ball throws

ABC balance exercise on bosu

40 lunges both legs!

Ab/pushup circuit

hip exercises

PT exercises

Stretch

Ice.

Day 96: Inspiration

I have reflected a lot about my situation over the last few weeks. I was so so close to being through the rough part of recovery before I got this second major blow. My surgery was absolutely traumatic the first time, requiring me to stay in the hospital for 4 days, nerve block didn't work, nor did the narcotics. I can't believe I have to go through that again!!! Ahhhhh! Well at least when I have a baby one day it should be easy compared to this, right?

I came across two quotes that helped me pull myself out of the darkness. 

"Don't let what you can't do keep you from what you can"

"Don't cry because it's over, smile because it happened"

I have refocused myself on finishing my PhD...which I am weeks away from finishing, because while it's hard to get around and a struggle to do the simplest tasks, my brain is just fine. However, now it is apparent that I will have to defend my dissertation in a cast from a wheelchair....yippee.

The second quote inspired me to dig up some of my old race photos and reminisce on how much fun I had. I was literally having the time of my life and the smiles I have on my face on my finish photos are absolutely priceless. No faking that kind of happiness. I know that being positive about all of this stuff is something I have to work on daily, so I am not out of the woods by any means, but it did help me to remember what has come before in my life. I am even more motivated to get back to the place that I can walk out of the door and go do anything physical that my heart desires.

Staying positive...for now.

Day 94: Gym Workout

My therapist guilted me pretty hard yesterday about not going to the gym in a week.  He told me that I have to stay committed.  Even though I have all but given up on myself and my chance to recover, he has not.

I was so hesitant about going back to the gym, because I knew that I would have to return to such a limited list of exercises.  I went anyways.

10 mins bike hill program

4 x 10 circuit:
~50 lb lat pull down, seated rows
~level 7 arm machine
~70 lbs leg extension/leg curl
~30 lbs single leg press
~20 lbs leg press calf raises

4 x 10 balancing exercises on the mat
(leg abduction, forwards, backwards)

3 x 30 sec balancing on the mat

4 x 10 left leg abduction/knee raises

3 x 10 24 lb bar deadlifts/shoulder shrugs

2 x 10 back sit-ups w/ 5 lb weight

2 x 20 sec plank circuit

20 mins bike pyramid program

PT exercises.

Ice.

Day 93: PT Session #16

Boy are these sessions getting even tougher to bear.  It is hard going to therapy, when I have lost all of my motivation.  Before, I was fighting to maintain my fitness and improve as fast as possible so that I could return to running and racing.  Now that my second foot is shot and another surgery is inevitable, what is the point of working so hard?

In the light of the recent Boston Marathon bombings, my therapist told me that he wants to run a marathon and try to qualify.  I told him straight up that it is really challenging to qualify for that race, and to run a marathon at all.  He and another one of his clients asked me all of these questions about marathon running and what kind of training it takes.  It was painful to talk about it, but it also felt good to share my experience with them.

My therapist asked me to bring him in a marathon training plan at my next session.  I am not sure yet if he knows exactly what he is getting himself into.

Day 92: Grocery Store FAIL

I went to the grocery store as I generally do once per week.  For the last several weeks, I have had no issue pushing a cart like a normal person and getting my shopping done.

Less than 5 minutes into the trip, I realized that both of my feet are too weak to be the primary weight bearer when standing.  Since grocery shopping is a lot of stop and go, it was too much for my feet.  I literally had a break down in the middle of the store because of how much pain I was in.  I held myself together enough to not cry, but only long enough until I made it to my car.

Cross grocery shopping off my new list of abilities.  Also add standing in the shower...haven't been able to do that for a week now.

I have made so much progress with my left, yet here I stand, back to my pre-surgery disabilities.

Day 91: 13 weeks + PT Session #15

*13 week surgery anniversary*

I wasn't sure how this session was going to go.  I hadn't seen my therapist since last Thursday, BEFORE my right ankle had collapsed.

When I got there, my therapist wanted me to take my ankle brace off and warmup on the arc trainer.  I had rehearsed in my head over and over how I would break the news about my right foot to him, but I wasn't expecting to have to spill the beans so early in the appointment.  I had to tell him, because with my right foot collapsed, this means that I can no longer do any weight bearing exercises that involve that foot.  This will MAJORLY limit the recovery of my left.  I was just starting to add exercises back that required me to be standing and weight bearing.

I told him straight.  "I don't think that that is such a great idea, because my right foot has fully collapsed and I can no longer do a single heel raise."

He stood there in shock.  We both knew that the right was not in good shape, but we didn't expect it to fully collapse anytime soon.  He told me to get on the bike and then told me to explain what had happened over the last few days.

I told him that I am in complete mourning over the death of my running career....for at least another year, if I can ever run again.  I changed my tennis shoe laces to black and painted my toenails black.  My chances of returning to running again after having both of my ankles completely reconstructed is slim to none.

I told him how I had cried every day since my ankle collapsed, but that I was trying to make it one day without breaking down.  He told me that if I cried during an appointment, he would also cry.  I don't think that he knew in that moment how much that show of support meant to me.  Having the support of my therapist is the only reason that I am still hanging on.  I literally would have quit and given up already if it weren't for my therapist that believes in me and my recovery more than I believe in myself at this point.

The appointment was tough to get through because I had to cut back on all of my exercises.  My left was hurting, because now it is compensating for my right, which is completely non-functional.

Day 89: Laser Tag

For one of my friend's birthdays, we went to play laser tag.  I knew full and well that I wouldn't be able to do much, but since I could stand, I figured I could just find a high place and aim at people from there.

I did indeed use that strategy.  What I wasn't expecting is how scared I felt knowing that I had no fleeing, or dodging capabilities.  At this point, I can't make any fast movements.  I stood frozen in terror, thinking that if I was in a situation in real life, I wouldn't be able to escape.  The laser tag experience had me visibly shaken up for the rest of the day.

Day 88: Consequences

So remember what I said about going through a full day without thinking of the potential consequences...

Well...my body paid me back for mistreating it.  I had to spend the whole day resting in bed...on a SATURDAY!  I iced and elevated all day and was forced to stay off my feet.  My feet hurt so bad that I was literally limping to even make it to the bathroom.

Not sure if I will ever be so bold to push my feet so far again.

Day 87: Me Day

After having such a rough day yesterday, I had to take a ME day.

I got my hair done, went shopping, went to happy hour, AND out that night.

My feet protested the entire day, but I completely ignored them.  I hate all of the limitations they have put on my life.  This was one day that I just threw my hands up and simply didn't care about any potential consequences.

I have been such a good patient.  I have followed all of my doctor's and therapist's instructions and restrictions.  I have iced and elevated my feet religiously, rested, eaten the right foods to help speed up my recovery, done my PT exercises, and stayed up with my workouts.

That obviously has worked for my left...but my right didn't get the memo.

Day 86: Right Ankle Collapse :/

I started the day by making the trek to the custom orthotics place.  I was right on time for my appointment, but he was running an hour late!

I was already annoyed for having to wait so long.  When he finally saw me, he edited my left orthotic to fit my new surgery foot.  When we were finished, I asked him if there were any orthotic shoe stores around.  He told me that he wouldn't recommend any because all of the shoes that they will have will be extremely unfashionable.  He said that I am looking at a life time of ugly, bulky, conservative shoes.  He said my best bet is to try to find regular shoes that I can have adjusted to fit my orthotics.

When I left, what he said didn't hit me until I had driven for a few minutes.  When it did hit me, I felt so hopeless.  Beyond my love for sports and physical activity, I absolutely L-O-V-E fashion.  I have such a fly wardrobe and enjoy killing it from head to toe.  I now know that I will never be able to just shop in the regular shoe section.  This reality hurt....and bad.  

I had to suck it up to take care of a number of things back at school, and then I had PT.

I was still so shaken up that I dropped all of my acetaminophen pills that I had brought for the day on the floor of my car.  I managed to pick up two to take before PT.

PT Session #14

7 minutes warmup on the bike.

Walk a lap.

To the tables for a scar tissue massage and flexibility work.  When I was removing my silicone gel pads from my scars, my hands were shaking.  I couldn't manage to peel them off and place them properly in their case.  My therapist told me to take my time.  He could already tell that something was wrong.  Most days, I try my best to not let anyone see how bad I am suffering.  I put on a smile and a positive attitude and hope for the best.  Today, I just couldn't fake it anymore.  My therapist asked me what was wrong.  I was really hesitant to open up and tell him the thoughts that were rushing through my mind, but I also knew that I could no longer hide.  I started by saying that I am just trying to hold everything together...that is, all the terribly shattered pieces of my former life.  I explained to him the depth of loss I felt with the latest blow of never being able to wear normal shoes again.  All in all, I must have known that this was going to be a rough day...

Later in PT, I had a really weird sensation in my right foot.  I could not bear weight on it for about a minute.  I thought it was strange, but since I wasn't doing anything that was directly engaging it at the moment, I didn't think it was anything major.  I didn't even tell my therapist because the sensation didn't last long.

Oh how I wish I had known what that sensation meant...

-------------------------------

Later that night, I went home and did my PT exercises and abs and pushups as I normally do on PT days.  I broke down and completely lost it while I was doing pushups.  Moments later, I tried to do a single heel raise with my right "good" foot, and realized for the first time that I could no longer do it.  That sensation that I had felt in my right foot during PT...yeah that marked the complete failure of my right posterior tibial tendon.  Failing to do a single heel raise is the last warning signal before becoming a surgical case.

Remember how my doctor said I MAY have to have the same surgery again??? Well, now that is a GUARANTEE.  I HAVE TO GO THROUGH THIS ALL AGAIN!!!! 

Also recall how I was 3 weeks away from learning to run again??? Yeah...that is not happening for at least a year from now.  Thanks doctor for getting my hopes up.

I continue to ask myself how much an extremely healthy and formerly active 25 year old can take...and exactly what did I do to deserve all of this torture???

Day 84: 12 weeks + PT Session #13

*12 week surgery anniversary*

Made it 12 weeks!

At PT, I had to tell my therapist all about my post-op appointment yesterday.  I told him all of the good stuff about how well my left was progressing and how my doctor said that we can start pushing it more.  He must have known there was some bad news that I was selectively not telling him yet, because he confronted me about it.  I told him about the strong possibility of the second reconstructive surgery.  I didn't actually feel the full weight of it until I said it out loud to him.  In that moment, I started recalling how difficult and traumatic the first surgery was.  To lighten the mood, my therapist joked with me about how I couldn't have just sprained an ankle or something...

Calf raises continue to be difficult for my right foot.

Day 83: Post-op Appointment #3

I went into this appointment with a lot of excitement over how well my left ankle has been progressing.  The transition out of the boot was tough and painful, but all worth it for where I am now.

We took X-rays and my doctor inspected my foot.  He said that my ankle is well ahead of schedule, but also said that my foot won't feel fully normal until the 9 month mark.  That is such a looooooong long time from now.  He also said that my bones are completely healed!  He ordered me to get my custom orthotics re-fitted for my left foot and to wear them religiously.

Per usual, I went in with a list of questions.  Here they are with my doctor's responses:

Questions

1) What should we do about my right foot?  I have noticed that my right foot seems to be more collapsed than it was before my left foot surgery.  The doctor confirmed that it is worse than when he started treating me for my left.  He told me that I would likely have to go through the same exact surgery for my right.  My eyes went wide and I froze in terror.  I had expected him to say it was going to be a less severe surgery...but he said it would be the same COMPLETE ANKLE RECONSTRUCTION! He said not to worry about it now, but that we would check on it at my 6-months post-op mark.

2) Left Foot Timeline? 

~Start weaning off brace now
~Don't have to sleep with the brace at night
~Can wear regular shoes for special occasions (only if I can walk in them!)
~Working up to running in 3 weeks
~Inversion/Eversion exercises allowed

3) Can I take ibuprofen again? Yes.  Your bones are completely healed.

4) Can I ride my bike outside? Yes!

-------------------

I left the office with a prescription for new orthotics (with a diagnosis of Bilateral PTTD...so sad), a new PT prescription to progress my left to higher impact activities and to work on saving my right foot, and a paper that I now have to carry with me when flying in case my ankle hardware sets off the alarms.

This appointment was full of tiny victories that I was excited for, but I couldn't shake the fact that I may be looking at getting the same surgery for my right.

Day 82: 600m Swim

Today, I decided to try the pool again.  My first attempt at swimming a few weeks ago was really challenging.  I largely underestimated needing good weight-bearing ability to get in and out of the pool.

Since my first pool workout was only 300m, I didn't want to push it too much, so I went for an easy 600m.

100m Warmup
8 x 50m Easy
100m Cooldown

My ankle is still adjusting to the kicking position, but it didn't bother me much.  My form is still pretty good, just not as smooth as before.

Day 81: 0.5 Mile Challenge!!!

I woke up early to workout before going to an event.

I was determined to make more progress on the treadmill.  I warmed up with 10 mins on the bike...and then hopped on the treadmill.

I made it 16 mins at 2.0 mph for a half mile!!!  My heel was really sore when I finished, but it was bearable considering I was able to walk faster and for longer.

Then...

24 lb body bar, 3 x 10 squats, shrugs, deadlifts, clean shrugs

Leg press- 2 x 10 (60 lbs), 2 x 10 (70 lbs)

Shoulder Circuit

4 x 10 (60 lbs) Leg extension + Leg curl (70 lbs)

Abs/Pushups.

PT exercises.

Stretching.

Ice.

Day 77: 11 weeks + NO ASSISTIVE DEVICES!!!

*11 week surgery anniversary*

Today, I made it through the whole day without any assistive devices.  I didn't bring my crutch in to school with me.  As you may recall, Tuesday's are my most rough days filled with meetings and teaching.  My ankle brace and shoe were all I needed.  I am still walking really really REALLY slow...but walking is walking.

Day 76: PT Session #11

More progress.  For some reason, I must have told the story about how hard it is for me to walk even 5 minutes on the treadmill around 1.0 mph for between 0.1-0.15 miles in a funny way.  I think the whole rehab room busted out laughing when I said that I was proud for going 1.2 mph for 0.15 miles in 8 minutes...which is such a far cry from running around 6.0 mph for miles and miles and miles, and not only miles, for hours and hours and hours.  That is the life of a marathon runner.

During the session, my therapist decided to pull an April Fool's joke on me and told me that this was my last session.  I literally was in utter shock because therapy has meant so much to my recovery.  No way am I ready to continue this journey on my own yet.  Luckily, it was just a joke and he took it back.  Based on my knee-jerk reaction, he was apologizing the rest of the session.

I did so well at the session, my therapist wanted me to stop using the crutch.  So, no assistive devices, other than just my ankle brace, from now on.