Day 66 (206): PT Session #11

When I woke up, my feet were sore, since I sat in a chair at new faculty orientation all day yesterday.

I had therapy again at 8:15 am, so my feet didn't have much time to recover from yesterday.  I was wincing a little bit with walking, but I again chose to go with just tennis shoes without the ankle brace.

For therapy, I started by riding 7 mins on a Schwinn Airdyne bike (with the arm handles and big air wheel).  I haven't ridden one of those in a very long time.  We thought that would be a little easier on my feet than the elliptical.

Next, I stretched my calf on the block for a few 30 sec holds. Then, back on the waffle board.  Today, I did squats while balancing on the board.  Those were pretty easy since I have been practicing squats at home.

After, I did a new exercise.  My therapist had me put a strap on my left ankle and he attached a weighted cable to it.  I had to balance on my right leg while moving my left leg back 10 times.  I had to do this in all four directions (both sides and then forwards).  When I finished with the right leg as the support leg, I had to do the exercise with my left leg as the support leg.

Next, we went to the table for manual therapy.  He worked on my toe and foot flexibility first.  He said my big toe is tight, but that the rest of my foot feels pretty good.  After he worked on my calf some, and also did e-stim and ultrasound on it.

When I was done, he wanted me to walk for him.  I always feel so off balance after he has worked on my calf.  He said that I was thinking too much, but if I don't think, I will fall on the ground.  I have to tell my feet every step to strike the ground with my heel, roll forward, to push off with my toe, and to place my foot straight. Nothing is automatic about my walking at this point.  

I also feel like I am falling to the outsides of my feet.  This is one of the results of the surgery, that you go from putting a lot of weight on the insides of your feet to the outsides.  That is the point of the lateral column lengthening (bone wedge).  I have had pronating feet my whole life, so this is an entirely new sensation.  My therapist also thinks that wearing motion control tennis shoes and orthotics, on top of having my feet reconstructed is over correction.  He wants me to transition to more normal stability shoes. Before I can do that, I need to do some serious balance training.  My motion control shoes keep me from falling since they are so stiff.  The more give in the shoes the stronger my feet need to be on their own at stabilizing me.  They are not at that point yet.

When I was done, I changed into my work clothes and went straight to school to finish my orientation.  I was late, because it started at 8 am, but I wasn't going to cancel my PT appointment for it.

After, I got in the car and rode with my parents to a family wedding.  I put my suitcase in the back seat and put a huge pillow on top of it so that I could elevate my feet. By the time I got in the car, they were begging me to elevate them after PT and sitting in a chair for another 4 hours.  My calf was aching.  That e-stim and ultrasound combo really stresses it.

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Reflection

More swollen and achy feet. More therapy. More struggle.  The journey continues...

Day 65 (205): The first day of the rest of my life

Today was a big day for me.  I attended the New Faculty Orientation at my new university.  This was my first official day of my first real job.  A major turning point.  This all just got real.  I am no longer a student, I am a faculty member!

My generally super confident self was horribly nervous to show up in tennis shoes with my ankle brace to my first day.  First impressions are everything, and I didn't know how people were going to react.  At my previous university, it was almost like it was a burden for them that I was going through these surgeries.  They made me feel quite guilty that I had to choose my health over some of my academic pursuits.  Imagine that?!?!?!

How I expected this new university to receive me was completely opposite from my experience today.  That is exactly why you have to drop your expectations.  They welcomed me with warm, open arms, and were sincerely curious and sympathetic of my feet condition.  It became more of a joke that I am an exercise scientist with injured feet than that it will be an inconvenience for people to have to walk slower when walking with me, or that I have to drive and move my car around campus, because I can't just walk across it, or that I need to sit and rest my feet ever so often.  They were all encouraging me to continue in my recovery, so that soon, they will see me at full strength.

They give me a lot of hope.  I feel the most supported I have ever felt in this lonely journey.

My feet were swollen and painful by the time I got home.  This was from sitting in a chair all day.  The worst possible position for my legs is with the 90 degree bend at the knee caused by sitting.  My feet really still need to be elevated, and if they are not elevated, they need to be propped up at waist level for as many hours of the day as possible.  I did pump my feet and flex my quads all day to keep the blood pumping, but gravity is no one's friend.

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Reflection

I am at peace with my feet at this point.  I think that I have finally pushed past the heartache and am starting to look towards the future again.  When people asked me about my feet today, I was able to talk about them without bringing up all the pain and emotions of how hard I have struggled for the last year and a half of my life.  Before now, it has been painful to talk about my feet and tell my story, and to imagine how limited my future life may be.  In this environment, I know that I will be ok.  I know that someway, somehow, I will get my active lifestyle back.  Ultimately, I know that I made the right choice in choosing this university, and that is really validating.

Day 64 (204): PT Session #10

PT was at 8:15 am!  Since the move, I have been on a terrible sleep schedule, so it was hard for me to wake up.  I just can't convince myself to go to sleep before 2 am.  I didn't wear my brace in, just my tennis shoes.

We started with 6 mins on the elliptical.  This was my first time on the elliptical since the second surgery.  My feet were fine.

Next, I had to stretch my calves on the angled stretching block.

Then, I did two new exercises with a waffle board.  It is a wooden board with a half circle cylinder on the bottom.  I had to balance on it without letting the board move side to side.  After that, my therapist turned the board around so that I had to use it to work on my front to back ROM by leaning all the way forward until the board touched the ground, and then all the way backwards, 30 times.  I did one more round of these two exercises.

Since my therapist thought that my right calf was tight when looking at me do the waffle board exercises, we did manual therapy.  He deeply massaged my calf.  One part of it was really  tight, so he dug in deep, and that was pretty painful.  Next, he put an e-stim patch on my upper calf and did ultrasound on my lower calf.

He asked me about how my toe yoga exercises were coming, and I told him I could do it.  He wanted me to show him while I was laying face down on the table.  I exclaimed, "You want me to do it without looking at my toes?"  He laughed and said, "YES!"  I told him that I can't do it, that I can't do much with my feet without looking at them.  He also asked me about spending time barefoot at home.  Another thing that I can't do, since I can't make it more than 5-10 steps before the pain comes or stand in the shower for more than 10 secs.  You guys already know the laundry list of things I can't do at this point, so I don't have to re-hash them.  After he said, "Do you know what therapists hate to hear the most?" I quickly answered, "I can't."  I really can't do a lot of things at this point.  It isn't an attitude issue, it is my reality.  He wanted me to show him that I can do the toe yoga without looking at my feet.  I could just barely do it, but only because he gave me verbal feedback that it was right.  I can't feel that I am doing it myself, I really do have to look at it to confirm.  I have lost most of the proprioception of my feet.  To not get too scientific, my brain sends the signal of what it wants my feet to do, but the receptors in my feet don't send the information back to my brain to confirm that the movement is correct.  That is why I have to use visual feedback, I can't just sense that I am doing the movement.

For hw, he wants me to try to do the toe yoga exercises without looking and also to do my balancing on each leg with my eyes closed.  All I can say is that I'll try, but this is not going to be easy.

After 1 hour, that was it.  I am used to doing much more in a therapy appointment.  I usually start with 6-8 mins on the bike, then manual therapy for 10-15 minutes, 30-45 mins of strengthening and ROM exercises, 15-30 mins of cardio, and 15 minutes of GameReady on both feet.  At this clinic, you get up to a solid hour of 1 on 1 time vs. 30 mins at my previous clinic, but the total treatment time is much less.

When I left, I felt like I had done a warm-up.  As soon as I got home, I took matters into my own hands and did a 15 min walk around my building, and then went to the gym.

I rode the pyramid program on the bike for 20 mins.

Then...

3 x 10 squats (15 lb dumbbells), shrugs (20 lb dumbbells), deadlifts (20 lb dumbbells)

30 bilateral front step-ups while holding 10 lb dumbbells

40 lateral step-ups with each foot

Back to my apartment for my entire home exercise program.

Ice.

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Reflection

Again, you are in control of your own destiny.  Don't complain.  Put up or shut up.  Period.  So...now I have to do most of my therapy exercises on my own.  It's only uncomfortable, not impossible.  Nothing that I will let stop me from making a full recovery.

Day 63 (203): 9/29 week update

*Right: 9 week surgery anniversary*

*Left: 29 week surgery anniversary*


My feet are doing well.  I challenged them yesterday by going to the mall for a few hours.  I had to take several breaks in any chairs that I could find.  The whole experience would have been much more enjoyable for me if I took my walker, but then I wouldn't have gotten in as good walking practice.

I did find two "goal" pairs of clark shoes, for once I start transitioning out of tennis shoes.  Still in the old lady collection, but as stylish as I could find.

A message to my readers

Dear Readers,

A few days ago, I received a lovely comment from a fellow PTTD sufferer.  If you want to read it, you can find it posted on Day 40.  These last few days have been rough for me personally with all of the transition I am going through in my life, while still having to deal with my surgery recoveries.  This comment arrived at the PERFECT time and inspired me to get back caught up on my blog, since I fell a little behind with my dissertation defense and moving.  It also motivated me to keep moving forward in my recovery. Over the last couple of days, I have added from day 41 to present, so get caught up! :)

 I started this blog to provide information about what it is like to actually go through an ankle reconstruction surgery, or two.  I am a researcher by trade in a field related to orthopedics and even I found it difficult to find detailed information on what to expect in the long road to recovery.  There are plenty of articles describing the condition and the surgeries, but little about life afterwards.   Particularly, no information about athletes going through this and returning to activity.   It is not a so uncommon running injury, just rare for my age, and really rare for me to have it in both ankles.  From my canvasing of the internet, it seems to me that most people just throw in the towel, quit running, and live with the reduced function of their feet.  Many never have surgery and rely on braces and assistive devices for the rest of their lives.  Others have the bones fused in their feet to obtain a "perfect" arch, but automatically give up the ability to run again because their feet are too stiff.  As such, I am kind of in unchartered territories trying to get back to it.  For me, giving up my active lifestyle entirely was simply not an option.  At 25, I am much too young for that, especially since I am an exercise physiologist.  I would be a total hypocrite in my profession if I accepted not being able to walk, run, or participate in moderate or vigorous physical activity ever again.

There are many more of you who have left comments or contacted me in some way and I appreciate every single one of you.  As much as I inspire you, you inspire me.  I love hearing your stories, although I so wish that none of you would have to go through this.  If you are reading and haven't commented, please do!  Also, if you have any questions for me or want me to address a particular topic in my blog, ask me!  I read every comment.  I want this to be as much of a resource for all of you as much as it is my way to cope with my situation and to document what I have been through.

In closing, you know from reading my blog that all of this is rough.  Every part of the recovery is difficult.  However, it is much easier being armed with knowledge and having others to relate to.  Please don't suffer in silence as I have at times.  Share your story, reach out to others, find your own way to get through the obstacles in your life.  As bad as this all has been, I have grown tremendously in this process.  Apparently, everything has a silver lining, so keep pushing until you find what it is for yourself.  And...

DON'T EVER GIVE UP.

Sincerely,

AA

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My silver lining is my new life goal:

200 DAYS!!!

Today is Day 60 (right) and Day 200 (left)!!!

200 DAYS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Let's see...what has changed since day 100?

My left foot is feeling more and more normal day by day.  It barely swells with exertion anymore.  It does ache at some of the incision points and at the tendon transfer, but I wouldn't call it painful, not compared to the real pain I have experienced this year.  At day 100, I was unsure of my right foot's fate.  Now we know, that I had to go through another reconstructive surgery.  The good news is that my right foot at day 60, is basically where my left foot was at day 100 (walking in my tennis shoes without a brace).  My recovery is going exceedingly well at this moment.

Here are some picture updates:

LEFT (Just over 7 months)

RIGHT (Just over 2 months)

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Reflection

I have come a long way and I have the scars to prove it.  I just have to keep fighting.  I still have a lot of work to do, but the end is much nearer than it was on Day 1.

Day 59 (199): Working on my walking

Picturing my former therapist coaching me in my head, I have worked really hard on my at home exercises the last few days and have been working on my walking.  I live downtown in my new city, the same as I did in my last city, so it is really conducive to walking.  I have started to walk a small loop around my apartment 2 times per day.  Each time I go one extra block to progress my tolerance.  For my new therapist, I have been doing this without my stirrup brace, just tennis shoes.  

My walking is really....really...REALLY slow.  The important thing is that I am doing it.  No assistive devices, no braces.  You have to start somewhere.

When I get to the edge of my abilities, I start feeling pressure in my right heel.  That is my signal to go back home.  So far so good.  I would estimate that I can walk almost a half a mile at this point.  I can definitely go for 20 mins without issue.  I'll have to either track my next walk with the gps app on my phone or try on the treadmill to have an exact distance.

My toes are responding well to their little yoga exercises.  I can actually control my big toes now and have no issue moving them separately from my other toes.  Practice makes perfect :)

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Reflection

Make progress.