Day 28 (168): 6 month report

*Right: 1 month (4 week) surgery anniversary*

*Left: 6 month (24 week) surgery anniversary*


So here I am, 6 months post surgery I and 1 month post surgery II.

Where did I think I would be at 6 months?  Running.  Preparing for a triathlon. Going to the beach.  Going out.  Shopping. Enjoying my last summer in my college town.

Where am I instead?  Stuck non-weight bearing in a boot on my right foot, still going through hell.  My left foot doesn't cause me any pain anymore, so that is definitely a success of the surgery.  It is still tight and achy, mainly in the mornings and at night.  I can't do a single heel raise on it yet.  I definitely can't hop on it either, which has made this non-weight bearing stage much harder.  I really hope that the delay in it's progression due to having to go through surgery on the right won't prevent it from fully recovering in the long run.

This post is hard for me to write because I had so many hopes and dreams before the first surgery of being back in action by summer, even if I couldn't race yet.  I expected to at least be able to train in my three disciplines (swimming, biking, and running).  It didn't really hit me until now, because with this second surgery, I have really tried to not focus on the things that I am missing out on.  The list would be as long as Santa's at this point.  I am putting all of my energy into my recovery, graduating, and moving on with my life.  No time for letting my mind wander into the depths of despair.

What have I learned?  

To be patient.  

To let go: of the past, of the future I had imagined, of the pain and heartache. 

To live in the present.  

To accept the things that I cannot change and that my life will never be the same.

To not take my health for granted.  

To focus on small successes.  

To find the light in hell, some semblance of happiness, and things to laugh about.  

To work hard and keep going even when the finish line is nowhere to be found. 

To get my work done under any circumstances.

To live a sedentary lifestyle.

To tolerate watching tv and sitting on my butt all day long.  

To cross-stitch. 

To navigate life on one weak foot while the other recovers from surgery (twice).

To ignore my footwear not matching my outfits and being ridiculously unstylish...well only outside of a nursing home.

To focus on the things that are truly important in life. 

and...

To believe that quitting is not an option.

Day 23 (163): Never Quit

Last night, I finally got a decent night of rest.  I calmed my mind and body and just relaxed.  No question that I was still extremely uncomfortable but I forced myself to ignore it.  I still woke up by 7 am, but I slept much better.

As the details of my new job get more finite, I had the idea to figure out where I would be with my recovery upon moving, starting my contract, and the semester starting.  What did I do?  I re-read my blog from the 6-week mark forward and correlated that with my current surgery timeline and my calendar.  I didn't realize how useful keeping this blog would be.  I remember my milestones, but I don't remember the specific days they happened on, but my blog does!  It was also great to re-read all the questions that I asked my doctor at my post-op appointments.

As I mentioned in an earlier post, the biggest difference is I haven't been able to ride my bike this time, because of the difficulty I have mounting it with my new left foot.  Since yesterday was a good day, where I realized I can make it farther on my walker than I thought, I decided to make the trek to my building's gym.  It is a small hike from where my apartment is located.

Yes...you heard that right...me...in the NWB stage...took a walker to the gym.  I know I am crazy but I need to work on maintaining/slowing the decline of my fitness if I want to recover as quickly when I get to the PWB stage as I did the last time.  I did two circuits of all the seated machines, primarily doing arm work.  I was also able to do single-legged extensions, curls, presses, and calf raises with my left leg.  I did a shoulder circuit and shoulder presses with dumbbells, while standing with the help of my walker.  In addition, I did some body weight work with my left leg since there are rails for me to hold on to at the gym.  I did single leg squats, leg abduction/adduction, and knee raises.  When I got back to my apartment I did abs and my PT exercises for my left foot.  This workout completely exhausted me, so I'll only be able to go every few days.

After showering, eating lunch, and resting while icing and elevating,  I took out the trash (scooting it on my walker), cleared and re-loaded my dishwasher, and marinated and grilled some chicken for my dinner.

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Reflection

Day by day I am realizing that I just won't quit.  I keep looking all of the challenges I have doing activities of daily living right in the face and figuring out ways to conquer them.  I believe in myself with every cell of my being.  I will get through this.

Day 22 (162): Finding Independence

Today was one of those days where everything just goes right, where you get to see all of your hard work culminate to success.

This morning, I got contacted by my new university to start the hiring paperwork.  While I was working on filling it out, my advisor emailed me back the final draft of my dissertation for my approval before sending it to my committee.  We have been through 6 rounds of edits over the last 5 weeks, and I was starting to think that we weren't going to get it ready in time for defense this summer.  Which of course would mean I would have to extend my official graduation until December.  I have focused on keeping positive energy in my life and have been using the visualization techniques that I learned from my running days to will all of this to happen.  During the full marathon I ran, I kept focusing on seeing the finish line, pushing hard all the way to cross it, and the medal going over my head.  I refused to let anything happen other than that.  Now, I keep imagining over and over again my dissertation defense, my committee signing the official defense passed forms, and letting the celebrations begin.  With two major surgeries in the 6 months immediately prior to finishing my degree, I have been on a wing and a prayer trying to finish out my final requirements through all the pain, loss of my independence, and learning how to walk again.

The hiring paperwork I was working on needed my signature, so I had to figure out how to get it printed, scanned, and emailed back.  A few blocks from my building is an office services store.  My other option was to take public transportation to my university and use their facilities.  I decided to take a gamble and go on an adventure to the office supply store.

I set out with my walker and a determined mindset.  Nothing was going to stop me from returning the paperwork immediately.  I have worked tirelessly in my academic career to reach the highest point...a terminal degree in my field...a PhD.  Not only that, but all the sacrificed time and lost life opportunities compared to same aged peers, because I have had to commit wholly to 12-16 hr days for the last several years of my life, during the academic years, and straight through the summers, to make this dream come true.  I worked that hard to be in the fortunate position I am in, to have landed a full time job in my field, back in my home state, only 2 hours away from my family.  It feels good to know that my sacrifices were worth something.  Returning to school full time, just two weeks after my first surgery, and working on dissertation edits, just 4 days after my second surgery, was all worth something.

Dream job...landed.

My journey to the office store was difficult, taking me 20+ minutes, and several breaks, to go the distance of a leisurely paced 5 minute walk, but I made it.  I felt my foot throbbing in the boot.  It definitely swelled from the heat and the exhaustion of the trip.  While I was at the office store turning in my hiring paperwork, my advisor cc'd me on the email of my final draft being sent to my committee, proof that my dissertation is fully out of my hands now.  I am waiting on approval from them that it is ready to defend, and then we just have to set the date and time!

When I got finished, I decided to celebrate by eating out at a restaurant that was in the same area as the store.  I sat there relaxed, not rushing, for once in my life.  I took in the sun, and the people, and had an overwhelming feeling of relief.  All of this pressure to stay on this daunting graduation timeline through my surgeries, to find a job, and to figure out what to do with my life was lifted.

Later, one of my steri-strips fell off after my shower.  My heel is now starting to scab over.

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Reflection

On the same day, I sealed the deal with my new job, and with my current university to finish my degree this summer.  Things are finally going my way and I am starting to live the life that I want to live.  I have always lived by the quote, "A wise man does what he has to now to ensure success later in life."  I've made it to the later in life part...finally.  Even though my life has turned out very different than I pictured in the physical department, I am finding a way to keep my hopes and dreams alive, finding a way to stay positive through all of this, and finding my independence again.  Ultimately, I have chosen to find the person I used to be and figure out how to live her life, just with some special adjustments.

Day 21 (161): 3/23 week update

*Right: 3 week surgery anniversary*

*Left: 23 week surgery anniversary*


Today marks week 3, meaning I have survived a full week in my boot, and that I am halfway done with the NWB stage!

On Friday, my dad left, so I am on my own now, trying to survive until I can walk and drive again.

I have been completely drug free since Sunday.  It was hard to cut out the nightly Percocet, since it also knocks me out so that I don't notice how uncomfortable it is to sleep with my legs elevated, and with my right foot in a boot.  I haven't had good sleep the last few nights, but I am determined to stay drug free.

I feel good, my foot doesn't bother me much as long as I keep it elevated.  It is still rough dealing with my incisions.  I change the gauze dressing on them 1-2 times per day.  No bleeding, they just leak a clear fluid with a slight brown tint, especially when my foot swells from not being elevated.  It doesn't appear that they are going to scab as bad as my left foot incisions did when trapped under a cast, since I can wash them daily.  The steri-strips have survived a whole week.  I thought they might fall off by now, but they are still hanging on.

The wrench in the plan has been a skin infection that I got from shaving my left leg before my post-op appointment last Monday.  Since I haven't shaved in a while and used a razor that hasn't been used for a few weeks, my leg got infected with bacteria.  Just little bumps that started on my left leg, but since my immune system is weakened, they spread all over my body.  I went to the doctor to get it checked out, but it is nothing serious.  The treatment is just to keep clean with soap and water, and change clothes, sheets, and towels often.  I got the smart idea to wash with my surgical soap since it is anti-bacterial and anti-fungal.  I have been washing with that 2 times per day for the last several days and luckily it is all clearing up.  The problem is even though the bumps are pretty small and non-offensive looking, they itch!

I have been out of my apartment a few times since my dad left.  Each time, I have chosen my walker as my mode of transportation.  I put my right knee on it and use it as a scooter.  I have been able to go a few blocks away from my building and have ridden public transportation with it.  I try to do something adventurous, things I probably shouldn't be pushing myself to do, every couple of days to avoid feeling trapped by my injury.

I haven't been able to ride my road bike on its trainer much because of the difficulty I have mounting it with my left foot as my support foot.  It requires me to hop on an approximately 2 ft high stool and then position myself on the seat.  That jump is difficult with my new left foot.  It was no problem for my pre-surgery right foot.  I'll have to figure out something else to do for cardio.  Probably just means more walker adventures are in my future.  I also can't do all the single legged exercises that I used to do with my right, because I am not able to solidly or dependably balance on my left foot.  I am pretty much stuck doing floor abs, pushups, functional training, and PT exercises.  It really sucks, but at least I only have 3 more weeks of continued deterioration of the fitness I worked so hard to obtain.  When this is all over, I have some serious work to do.   I am certain I have lost every bit of the fitness gains that I have made in the last two years, everything since I decided to become an endurance athlete.  Even everything that I gained from PT over the last 3.5 months.  Both of my legs are devoid of muscle, and I have not 1 but 2 baby calves.  So sad.

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Reflection

Another week closer to the PWB stage, to my dissertation defense, to my move, to my new job, and to my new life.  Still staying positive, focusing intently on not letting this surgery get to me like the last one did.

Day 14 (154): Two weeks + first shower

*Right: 2 week surgery anniversary*

*Left: 22 week surgery anniversary*


Last night was my first time sleeping in the boot.  I thought that it was going to be really uncomfortable since it generally bothers me during the day, but surprisingly I slept much better than I ever did in the surgical splint or when I was in a hard cast with the last surgery.

With the last surgery, I started weening off my drugs after two weeks.  I have given myself the same challenge this time.  I have already cut down from 8 Percocet per day (2 every 6 hours), to 4 per day (1 every 6 hours), to 3 per day (1 every 8 hours).  The next challenge is taking only 2 per day.  I took 1 Percocet before bed, and today I took one at noon, and will take one more at 8 pm.  I also quit taking my blood thinner yesterday.  This means that I have to make sure to move around a lot more to make sure I don't get a blood clot.  My foot is much more achy and bothersome with less drugs, but I would much rather tough it out to be able to stop putting chemicals in my body.

First Shower

Around 1 pm, I decided to try taking a shower.  I took my boot and sock off, and unwrapped my foot.  I was happy to see that there were only small bleeding spots on my gauze pads, nothing major.  Next, I had to figure out how to get into the shower.  My shower is a stand alone glass shower, so at least I don't have to climb in a tub, but it still has an almost 1 foot ledge to step over.  I had figured out how to get over all these obstacles with my left foot surgery, but it is totally different with the support foot switching sides.  It is amazing how talented I became at getting around on my right foot for so long, now I am teaching my left to do things.  I still used a chair that I have in the bathroom to help me transfer to the shower chair, I just had to adjust my technique.

After about 10 mins, I finally figured out how to get in.  The advantage of my right foot being the surgery foot now is that it is closest to the door when I am inside the shower.  It is really easy for me to hold it out of the main stream of water.  My left leg was very sensitive when I returned to the shower after 6 weeks.  I learned that my right is much better off.  The two weeks away from the shower wasn't long enough for it to lose its tolerance for the heat or pressure of the water hitting it.  My left leg skin was so raw that it took weeks for it to feel comfortable.  Two weeks was long enough for an entire layer of skin to peel off my right leg and foot today.

When I got out, I let my foot air out some, and rewrapped it, iced it, and put it back in the boot.

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Reflection

2 weeks down.  In a boot.  First shower done.  Almost pain free.  Almost drug free.

Really happy with my status at this point.  Gotta keep swimming...

Day 13 (153): Surgery II Post-op Appointment #1

After staying up really late, or really early, working on my dissertation edits, I couldn't go to sleep.  I was as nervous as I generally am going in to appointments with my surgeon.  I finally went to sleep around 4 am, but had to get up at 6:30 am to have time to get ready for and make it to my 8 am appointment.

I got called back rather quickly this time.  I think it is because I was one of the first patients today, since my appointment time was so early.

An athletic trainer cut off my surgical splint/soft cast and removed my stitches.  Then she put steri-strips over the incisions.

My calf didn't atrophy as much this time.  Probably because it was so strong from being the primary weight bearing leg for quite some time now. The swelling in my foot is also minimal.

X-rays.

It looks like they added an extra pin where they put in the bone wedge.  I'll have to ask about that at my next appointment.

My doctor wasn't there today, so his PA handled my appointment.  He said that he talked at length with my surgeon about whether or not I could go to a boot instead of a cast this time.  He went through the pros and cons and instructions related to both choices.  He was very firm with saying that if I go to the boot, I still have to treat it like a cast.  I have to wear it at all times, except for showering or icing my foot.  I am also completely non-weight bearing for another 4 weeks. He wanted me to know that I had to treat the care of my foot seriously as if it were casted.  No matter what he said, I already had my mind made up.  I chose the boot, of course.  There is nothing worse than being stuck in something you can't get off.  With the boot, I'll be able to return to showering, clean and lotion my leg, apply ice directly to the wounds, wear more of my wardrobe, and most importantly, get to itch my leg!

Questions

1) Schedule of NWB/PWB/FWB?  Same as last time.  6 weeks NWB (4 weeks left to go), 2 weeks PWB in boot, 2 weeks FWB in boot, then on to FWB in tennis shoes while wearing an ankle brace.

2) When can I start PT? At week 6.

3) Can I ride a stationary bike with the boot before the 6 week mark?  No.  Well...that just means that I'll have to use my crutch to move my right pedal, the same as I did for my left with the last surgery.  Either way...I'll be returning to riding my road bike on its indoor trainer this week.

4) When will I be able to drive again?  Somewhere around week 7 or 8.  I'll still be in the boot, but I will be allowed to take it off for driving and will have to put it back on when I get out.

I found out that the boot that I had for my first surgery works for both feet.  If I had known that, I would have brought it with me to the appointment.  Since I didn't have it with me, they had to put another temporary splint on to protect my foot on the ride home.

There was some bleeding with the removal of the stitches and my not fully healed wounds, so I stopped by the pharmacy to get gauze pads and some medical tape to cover my incisions before stuffing my foot in a sock and then the boot.  This is one thing I didn't have to deal with last time. By the time I got the cast off at 6 weeks, my incisions were fully healed.

When I got home, I removed the soft cast and wrapped my foot back up to be placed in its new home...the boot.  It took me quite a while to get my foot fully down in the boot with my ankle at 90 degrees.  Once I did, it was pretty comfortable for the rest of the day.

Day 12 (152): More Dissertation Edits

My advisor returned my dissertation to me on Thursday afternoon.  With all the job search excitement on Thursday and Friday, and not feeling well on Saturday, I didn't get to work on my edits until today.

I worked tirelessly through the day and part of the night to make sure my advisor would have this latest round of edits waiting for him on Monday morning.

I feel good about the progress I am making and know that it is close to being ready to go to my committee.