Surgery II (5 months post-op Surgery I)

*20 week (5 month) surgery anniversary*

Here we are...exactly 5 months (140 days) post surgery I, going under the knife for surgery II.

[Today, I am 3 days post-op from surgery II and feel well enough to start posting again.  It took me 12 days after the first surgery to feel well enough to get back to my blog. ]

 Here is a recap of my surgery II day:

6:15 am- Alarm

I took care of some last minute personal affairs and wrote goodbye messages in cards to my parents and also in my journal.  When you have a surgery that you have to go under general anesthesia, there is a very real danger that you may not wake up, from the anesthesia alone, no matter how simple or severe the surgery you are having.  Add the severity of my surgery and there are an infinite number of ways that my surgery could have gone wrong.  Luckily, I am still here, so we know that it went well, but I still had to leave some final messages, just in case.

6:45 am- Shower with antiseptic soap

7:45 am- Arrived at the Hospital 

When I got to the hospital, I had to take care of some paperwork, and then I got taken to a pre-op room.  There, I changed into the surgery gown, answered a lot of questions from nurses and doctors, got a complete physical by the house physician, gave a urine sample, got my foot and leg shaved, and had the IV put in.  For my last surgery, they were able to put the IV in my hand, and I remember it being the most painful of my pre-op experiences.  This time, she couldn't find the vein in my hand, so she tried to put it in my left arm.  She stuck the entire IV in, and didn't hit the vein.  She bandaged that site up and then found luck in placing it in my left wrist.  Neither attempt hurt as much as placing the IV in my hand for the first surgery.  When the IV was secure, I was rolled to the pre-surgery staging area.

In this area, nurses and doctors asked me the same questions I had already been asked before.  It is amazing how repetitive the paperwork is, but I can only imagine how many mistakes have been made that it has to be that repetitive.  The anesthesiologist talked with me and talked me through the nerve block and anesthesia process.  As my doctor instructed me to do, I was deeply questioning him about the procedure and making it clear that it didn't work the last time and that it HAD to work this time.  While I was talking to the anesthesiologist, my doctor came to visit me.  He warned the anesthesiologist that I am probably the most intelligent and thorough patient he has ever had, so be prepared to answer my questions! I was laughing really hard.  I know that I have the distinct advantage, that I am in this field, and I actually understand everything that has to be done to me and why, but do patients really not do their own research about their conditions?  Being informed is the best way to prepare yourself when you have to go through life-altering surgeries like this.

My surgeon thought he was off the hook after signing my right leg (they come and put their initials on your surgery leg to confirm that they operate on the right side), but of course I had a few questions to ask him before he left...further validating what he already said about me.

Question 1: When is the earliest I can travel?  Up to a 2 hr flight is possible at 2 weeks, but it would be better if I travel no earlier than 4 weeks.  I asked him this because I am actively on the job market, and if I have to fly to a university for a final interview, I want to be able to tell them when I can go.

Question 2: When can I start PT?  When the bone sets, some time between 4 and 6 weeks.  I hope to convince him at my 2 week appointment that I will be ready to start at 4 weeks.  I am only 7 weeks away from moving where I currently live, so the earlier I can start PT, the closer I can get to being able to drive again, and walk upright (with some assistance) so that hopefully by the time I move I will be able to live independently in my new city.

10:30 am- TIME OUT

My surgeon left, and then it was time for the "time out" with the anesthesiologist.  I said bye to my mom and then moments later I was out.  The next thing I remember is being in the recovery room.

12:30 pm- Recovery Room

Same as last time, I was asked to wiggle my toes.  I could do it, but just barely.  I felt a numbness down the entire lower part of my right leg...which meant...THE NERVE BLOCK WORKED!!!  Instead of immediately writhing in pain, like after my first surgery, I was looking around taking the room in, asking for my mom, and I felt hungry!  My pain level was so low, that the worse pain I felt was my hunger pains! I was so happy in that moment...it was absolutely amazing the difference from my first recovery room experience.  My mom was only allowed to feed me ice chips while I was in the recovery room.  I wasn't allowed to eat or drink anything since midnight the night before, so it did feel good to have something in my mouth, even though it was just ice chips.

3:00 pm- Patient Room

After a few hours in the recovery room, they wheeled me to a private patient room.  As soon as I got there, I was ready to get up out of my bed and use my crutches to go to the restroom.  [With the first surgery, the nurse had to threaten me with placing a catheter if I didn't go before 11 pm the first day.  I didn't end up going until just before that, but I did avoid having to get the catheter.]  I told my nurse that I was ready to go, and she said that I wouldn't be allowed to without PT coming and confirming that I knew how to use the crutches.  I explained to her that I had the same surgery 5 months ago, and that I am very skilled with crutches, walkers, canes, wheelchairs, you name it!  She wouldn't have it.  She actually wanted me to use the restroom in a bed pan.  I told her that I wouldn't do it, and that I would wait until PT came.  She called PT and said that they couldn't come for at least another hour.  I held my ground.  Finally she said that I could get out of my bed and use a bedside toilet, which at least looks like a regular toilet.  The bedside toilet was only about 5 steps closer to my bed than the actual toilet, so I still can't understand all the fuss she created over me not getting out of my bed.

With my first restroom trip out of the way, I was back to being hungry.  I discovered that the nurses have turkey sandwiches on the floor that they can give to patients whenever, considering dinner was still several hours away.  Somehow, I never figured out the turkey sandwich secret with the first surgery.  I devoured the sandwich and then I felt like I had a lot of energy back.  I realized that the main reason I felt light headed at that point was because I was so hungry.

5 pm- Feeling pretty normal

By 5 pm, I felt well enough to be smiling for pictures and texting my friends, things that were absolutely impossible after the first surgery.  My pain level was around a 6.  It took over a week to get my pain level that low after the first surgery.  I ate dinner and waited for the PT.  I was able to feed myself!  The pain of the first surgery was so great, that I couldn't even focus long enough to use the fork to pick up my food and put it in my mouth, it was hard enough just to get myself to chew.  My mom fed me most of my meals in the hospital with the first surgery.

6 pm- PT Visit

Finally, the PT and his two interns came to visit me.  The therapist remembered me from my last surgery.  We skipped all of the normal introductory instructions and got right down to business, getting out of my bed!  It wasn't until I had crutched a few steps that I realized that the IV placement in my wrist was not going to work.  With the severe angle that you have to bend your wrists to use the crutches, I was painfully bleeding through my IV line.  I was only able to crutch to the door of my patient room and turn around.  They did let me go to the bathroom while I was up.  The therapist went and told the nurses that I needed my IV moved.  My session was over for the day since my IV line prohibited me from doing more.

7 pm- IV line moved

They had a lot of difficulty before the surgery finding an IV location, having to try two before they successfully put it in.  Now I was facing yet another puncture in my arm.  They used an IV line for a child this time and were able to put it in my right forearm.  This really complicated things because my IV pole was on the left side of my bed, which meant that the remaining time I spent in the hospital, I had all of the cords laying across my lap.

First Night

I was nauseas and itching- both side effects of the narcotics.  They gave me drugs for both of those.  I tried to keep pressing my pain drip on a schedule.  I was allowed to press it every 8 mins, but that is really difficult when trying to sleep.  I also had vitals and drug checks every 1-2 hrs, so not much sleep that night.  I went to the restroom about every 2 hours, which was much less than the 16 times that I had to go with my first surgery.  That was obviously a result of them having the IV fluids on high since I wasn't going, and from all the water and gatorade I was chugging to try to make myself go.  Around 4 am, I asked for another turkey sandwich.  Since I didn't have the pain to distract me from my hunger, it was time for some more food.

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Reflection

What a difference the nerve block makes.  Day 1 was closer to Day 7/8 of my first surgery.

Day 139 (-1): Surgery II Eve

So tomorrow is the day that I go through my second reconstructive surgery, this time on my right foot.

I honestly have been so busy with finishing my dissertation, traveling to and presenting at the conference, and interviewing for jobs, that I haven't had the time to really stop and think and process that I am about to go through this all again.  I also haven't had nearly as much time to prepare my apartment and my personal affairs for the rough road of recovery that I have ahead of me.

Mentally I have been going through the cycle of convincing myself that I don't need the surgery, don't want to go through the surgery, that it doesn't really hurt THAT bad, before I come to my senses and know that I need the surgery.  It is the same cycle I went through before my first surgery.  At my last appointment my doctor made it clear for me.  He showed me how misaligned my right foot is now, which is just as bad as my left foot was before.  No questions asked.  My right foot needs surgery to give me my best chance of walking normally again and returning to my activities of daily living, and in the best case scenario, to an active lifestyle.

Tomorrow I continue my fight to one day return to living life without pain in every step of every day.  I will have to learn how to walk for the third time in my life and for the second time this year.  It will get worse, waaaaay worse, before it gets better, but at 5 months post-op from my left surgery, I do know that it does get better.

At 7:45 am tomorrow, I continue this journey.

Day 127 (-13): Surgery II Confirmed

Today was a life defining day.

This morning I had my final pre-op appointment before my right foot surgery.  There was a different look in my eyes from the time I woke up.  It was a combination of worry, nervousness, sorrow, and excitement that I would finally know my fate.

I waited for just over an hour past my appointment time in the waiting room.  The earliest I have ever been seen is maybe 45 mins past my appointment time, so I knew before coming in today that I would be waiting. That 1 hour was excruciating.  I tried to listen to some music, but I ended up turning it off because it was as if my thoughts were shouting over the sound of it.   It was hard to not let my mind wander to the worst case scenarios.

When I finally got called back, I went and waited in a patient room.  Then, got taken to do some x-rays of my right foot, and back to the room.  More waiting.

Finally, my surgeon's PA walked in and went straight to the computer to pull up my X-rays.  He  showed me a comparison picture between my left before surgery when it was collapsed to my right now currently collapsed.  My feet looked literally identical.  Eerily similar.  No more questions at that point about if I was going to have surgery.

See for yourself:

My doctor came in and used the computer tools to draw lines on my talus bone that, when extended, were supposed to line up with my first metatarsal.   He demonstrated how my right foot is 15 degrees off, whereas my newly reconstructed left foot is only 2 degrees off now.  

He then checked out my feet.  He asked a lot of questions about how my posterior tibial tendon had been feeling.  I told him that it was not nearly as painful as when my left collapsed because that one was so badly inflamed from running.  With my right, one day, it just decided to fail.  I have pain and inflammation on some of the bad days, but mostly it is just intense pressure on the medial side of my ankle since it completely collapses when I walk.  We got to talking and he said that my case is atypical...OBVIOUSLY...we all know that at this point.  He told me that he thinks that if he fixes the structure of my ankle, that there is a good chance that my tendon will be fine.  

What's the benefit of not transferring the tendon? Less surgery procedures. Faster recovery.

What's the risk of not transferring the tendon? Another possible surgery down the road.

He really left it up to me, but I agreed with him.  I am only 25 years old.   I would much rather do less and take the risk of having to have another surgery, than do more than needed and risk not being able to run again with a transferred tendon in both feet.  The flexor digitorum longus that they use for the transfer is no where near as strong as the posterior tibial tendon. I will have to be very careful going forward with my left especially because of this.  

I came prepared with a number of questions as I normally do:

1) How rare is my case and why do you think this happened to me?  Really rare and no clue.  We both sat there baffled trying to come up with some type of explanation, but there really isn't any.  I fit none of the typical criteria for those who have this condition.

2) What can we do to better manage my pain for the second surgery?  I reminded my doctor that I spent 3 and a half days in the hospital, that the nerve block didn't work, that the dilaudid (hydromorphine) drip didn't relieve my pain, and neither did percocet.  He said that we have to really hope that the nerve block works this time.  He said that since it didn't work, my pain probably peaked too high before the drugs had a chance to do anything.  For pain management, it is all about staying ahead of the pain, catching up doesn't work.  I learned this lesson on my own after the first surgery.  I didn't think about it in relation to the nerve block and IV drugs.  So, we are going with the same strategy, just hoping it actually works this time.

3) Can I do one less week in the hard cast this time ( 2 weeks soft cast + 3 weeks hard cast, instead of 4)?  Yeah.  That will be fine.  Later in the conversation, he came back to this, and said that I can go straight to the boot after the surgical splint.   He said that the primary reason for casting after this surgery is to keep the tendon fully rested while it heals.  No matter what, since the boot comes on and off, there is no way to keep your foot completely still; however, this surgery is different.  It will primarily be bone work except for the calf and achilles lengthening.  I will still be non-weight bearing for 6 weeks, but he doesn't see a reason why I have to be casted, of course as long as I am compliant with the non-weight bearing.  There is no doubt in my mind or his that I will follow his instructions, so that will be the plan.  Straight to the boot after the soft cast!!! He wants me to start moving my foot around and working on the flexibility just weeks after the surgery, other than dorsiflexion which will affect the gastrocnemius recession.  This also means that I get to return to PT sooner, which means I will be back driving sooner, which means I will be ready to walk flexibility and strength wise as soon as I am permitted to start partial weight bearing, which means I will be walking with no assistance sooner, which means that I will get to work towards running again sooner, which means that I will get my life back sooner than expected.

4) I'm flying to a conference next week, any special precautions?  Yes.  Take blood thinners.  He gave me a new prescription for this trip and for after the next surgery.  

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Surgery II Plan: 

Medial displacement calcaneal osteotomy (saw off my heel bone and reattach it to the correct position with a titanium screw through my heel)

Lateral column lengthening (add an extra bone to assist with rebuilding a normal arch)

Gastrocnemius recession (lengthen my calf and achilles tendon)

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This appointment was so different than the ones before.  It didn't hit me until tonight that the major difference is that he didn't treat me like a patient, he treated me like a colleague.  With a PhD in Exercise Physiology, my field is not that far removed from the orthopedic world.  In fact, the two fields completely intersect and cross over each other.  Today, he told me everything straight, nothing was sugar coated, and he explained the scientific/medical reasoning for everything that he was going to do for this surgery.  Before the first surgery, he talked to me like I was a kindergartener.  Most people need their hands held and need to be sheltered from the truth. I am just not that kind of a person, especially when it has anything to do with science, especially medical sciences.  The way he treated me in our first encounter is not a criticism, it is exactly how he should have behaved.   My doctor has excellent bed side manner.  At the time, he didn't know me and my personality.  After all, I only met him one week before the surgery since I switched surgeons at the last minute.

I left the office feeling much better about my situation.  I know that my surgeon has my best interest in mind and that he is going to do everything he can to help me get my life back.

So the surgery prep begins...13 days and counting.

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Surgery Supplies

New Hobby: Cross stitching.  I searched long and hard at the craft store trying to come up with something that I would actually be able to do while sitting with my legs elevated for the next two months.  I got several designs that all have great and relevant messages for me at this point.  That section of the store was speaking to me, as if I was meant to find it.


~Lap desk with Laptop cooler for editing my dissertation and preparing for my defense after surgery.
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DISSERTATION

Put in more hours today.  I am not done yet, but I am inching closer and closer.

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Reflection

Today, my appointment with the doctor was much more laid back and casual than I expected.  I am looking forward to having the other surgery because I know that it is necessary to get me back to where I want to be.

I started prepping for my surgery and found a new hobby.

Found out that I have another job interview next week.  Now, that makes 3 interviews for next week.  I might actually get my first real job offer!

Made more progress on my dissertation.

The pieces of my life are starting to come back together.  You know what they say, "Bad times don't last always."

Whoa this is a long post...

Day 121: Surgery II Looming + PT Session #24

I am 19 days away from my potential second surgery and it is getting scarier and scarier the closer it gets.

I feel like I am standing on a plank.  If I fall off right, there are alligators in the water.  If I fall off to the left, there are sharks in the water.  The choice I have is to live this half life or quarter life rather, that isn't really living, with my whole routine limited by my feet or go through the trauma of another reconstructive surgery.  Neither are really options.  So here I stand on the wobbly plank prepared to fall.

Picture the worst thing that you have ever gone through in your life.

Now...picture experiencing it all over again, the entire scenario, 5 months later.

I haven't even mentally come to terms with the limitations the first surgery has put on my life, not to mention mentally prepare to start this process all over again.

Weeks and weeks of pain.  So much pain that I thought that I would actually die from it.

Weeks and weeks of non weight bearing, to partial weight bearing, to learning how to walk again.  

Weeks and weeks of physical therapy.

Weeks and weeks of missed opportunities and social activities with my friends.

Weeks and weeks of being stuck inside icing and elevating.

Weeks and weeks of no swimming, going to the beach, traveling, biking, enjoying life, period.

Weeks and weeks of seeing the life that I worked so hard to build continue to crumble right in front of me.
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Add letting go of the PT lifestyle, of which I have become so accustomed of, to my mental preparation list.  I have got a lot of thinking to do.  I hope my brain is ready.  Coping strategies...it is time for you all to kick in.

Next week is it.  I have two more sessions.  For so many weeks, the only thing that I have looked forward to is going to PT.   It kept me on a schedule with my recovery.  It reminded me that I couldn't quit and that I am not alone in this journey.  I have so liked going there because that is where I go to battle.  I fight for my old life back every session.  Not to mention that I get to do it with an awesome coach, confidant, and cheerleader wrapped up into one, my physical therapist, who is my personal superhero.

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Today in PT, we continued to do harder exercises to try to progress my left more despite my right.  At the end of the session, I did 20 mins on the arc trainer, and around minute 18, my left heel pain returned.  I haven't felt it in quite a while, but it also might be my fault since I did the Pike's Peak program (which is an extreme hill program).  I can't help but push myself sometimes.  This is going to sound crazy, but I thoroughly miss pushing myself to exhaustion, pushing myself to the point that sweat is dripping off of my body, to the point that anyone would be crying for their mommy.  I used to challenge myself to that level every single day before surgery, except for the occasional off day.  There is just an amazing feeling you get, like you can accomplish anything, when you tackle a hard workout.

That part of me is gone.  My competitive edge has been stolen.  Today, my challenge is to just make it through each day.  A successful day is when I can maintain my pain around 2-3 (which is only achievable by remaining completely sedentary and with the help of ice, elevation, and drugs) and not breaking down and crying over my situation.

My ankles were sore the rest of the day.

Ice, Ice, baby.

Day 111: MRI was inconclusive!

I got the phone call from my surgeon's PA announcing my right ankle MRI results.

They were inconclusive!  My posterior tibial tendon did not show the usual signs of PTTD.  This is startling because it is clear that my right ankle has collapsed in the same way my left did.

The PA said that I present all of the clinical signs, so he still thinks that I need the surgery, but that he wants my surgeon to make a closer examination.

He recommended for me to let my surgeon look at it the morning of surgery and then proceed or not proceed with the surgery.  I told him that that was not going to work.  I can't know the day of surgery if I am not going to be able to drive for 2 months.  I have to plan for that!  Later, a scheduling assistant called and recommended the day before surgery.  Same issue.  No planning time.  I was able to negotiate an appointment for Wednesday, May 22nd, which is still only 13 days before my surgery.  I am anxiously awaiting that appointment for final confirmation that I am going under the knife again.

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 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.

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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.

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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.

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 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...

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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???