What the f*!$ is wrong with your leg? Part 2

Day 1, Friday:

Once I got back home, everything that happened the rest of the day was a slight blur (thanks, Percy). I was in a decent amount of pain and just generally uncomfortable. My sweet in-laws brought mexican for us for dinner and I could hardly eat any. I later realized (after a few freak vomit sessions) that my antibiotic was super strong and left me extremely nauseous and light-headed. Luckily I was only on those for 3 days.

I had never felt more helpless and pathetic. I physically and mentally felt fine, I just couldn’t walk and do things I wanted to. I felt like a spoiled brat every time I asked for a glass of water or a snack or for someone to help me take off my pants before bed (sorry for the extreme romance, mangosquash, you are a lucky man). I tried walking a bit because the doctor said I should be able to, but hobbling around with 2 crutches around my tiny house proved pretty difficult. I did figure out a way to make it down to the basement (where the comfiest couch and biggest tv are) by hopping on one leg all the way down.

Iced leg

Sleep eluded me for the first few days. I was stuck in a strange in-between spot where my brain couldn’t seem to fully commit to falling into actual REM sleep. I can only compare it to the mind of someone who is experiencing extreme anxiety (of which I also suffer at times, fun stuff man); thinking so many thoughts and scenarios and ideas all at once and there doesn’t seem to be any sense or order to it. I blame Percy.

Day 2, Saturday:

Saturday was a BEAUTIFUL 70 degree day. My dad and husband went and bought us some new patio chairs, because I broke one of our directors-style chairs as soon as I sat down. Wah. My dad also went to pick up St. Louis-style BBQ for us for lunch from Bogart’s, the greatest place in the world. If you haven’t been and you’re from St. Louis, you are really missing out. We spent most of the day outside which pleased my dog to no end.

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Still in a good deal of pain, and more residual pain seemed to set in. My back hurt from sitting with my leg propped up, my knee hurt from being bent all night, my foot hurt from being so swollen. I’d rate it a 7/10. This is the day when the swelling and bruising really started to set in. Also, whenever I bent over or stretched my leg really at all, I’d get some tingly nerves shooting from my knee area straight down through my toes. Later, my doctor told me that it was because they had to move my nerve out of the way during surgery.

Day 3, Sunday:

My parents flew back to Michigan after spending 4 days with us and I can’t thank them enough for being here with us. I think my poor husband would have killed me. But first, my mother washed my hair for me. What a cutie-cutie-bonding-moment, as she would call it.

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My BFF Samantha also drove in that night to spend the next few days with me while mangosquash went back to work. Having her here was so fantastic; I can’t remember the last time we got to spend so much quality time together. I hadn’t seen her since finding out she was pregnant several weeks before, so it was excellent to chat all things baby. I got to take her 11-week bump shot with our chalkboard. Can’t even wait to be an aunt!

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My pain level was leveling off by this point; still on Percy, but down to 1 pill instead of 2 at a time. Super sore and stiff. About a 6/10 resting, 7/10 when I tried to walk around.

Day 4, Monday:

Spent the entire day outside reading magazines, eating snacks, and chatting about pregnancy and baby names. My in-laws’ wonderful best friend, Maria, came over to pay a visit and brought delicious food and beautiful flowers.

I finally got the guts to take the wrapping off my leg and inspect my stitches. Woah man, SO UGLY. Like a member of the Blue Man Group barfed all over my leg. I was pleasantly surprised with the size of my incisions, though; less than 2 inches in length each. Don’t scroll down if you have a weak stomach.

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Pain the same as before; wavering at about a 6 depending on my activity level. My ankle started hurting a ton from trying to walk more. Because of the swelling and muscle tightness, my foot wasn’t able to bend to a neutral 90 degree angle. Still having lots of tingly shooting fireballs down my leg, though they are getting better.

Day 5, Day 6, Day 7:

These days kind of blend together. Samantha left, and I was left to fend for myself. I also took my first bath/shower in several days. My poor husband. I watched a lot of bad TV and crappy Netflix movies, slept in until noon, and snuggled with my precious cat.

My pain level came down to about a 4 and 5, just super sore and tender.

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Yes. That IS a plate on my bathroom floor. I ate breakfast while I was in the bathtub. It’s fine, I was on vacation.

Day 8, Friday: One week post-surgery

My stitches came out on this day! I can’t believe they were ready to come out; my incisions didn’t look like they had healed at all. Nonetheless, out they came. I was still hobbling on two crutches at this point, sometimes using both feet, but usually just one foot.

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My doctor said everything looked great and instructed me to start physical therapy as soon as possible to build back up my muscle strength, range of motion, and get me back to running! Happy day! He also said I can go back to work whenever I feel strong enough.

Day 9, 10, 11:

Pain still about a 4. I only left the house a few times to visit with my in-laws and go out to eat, and I was starting to get a little antsy by this point! Still on two crutches.

Day 12, Tuesday:

I started physical therapy. My PT was SUPER great. She was a younger girl a year older than me, spunky, cute, really nice. She took measurements of my range of motion. My foot could move about 10 degrees total; not very much (normal range is about 60 degrees), and I couldn’t even get it to neutral (90 degree angle to the shin). I came in on two crutches and she had me walk around the office to observe my gait. I wasn’t able to pick my foot up comfortably; it hurt too much. She stretched out my muscles as much as she could and gave me some at-home stretches and exercises to do and sent me on my way.

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This was also the last FMLA day I was taking; I was returning to work the next day. I spent the rest of my day of vacation (Is that what it was? Sure was relaxing). I was in a fair bit of pain after working so hard at PT; maybe about a 5.

Day 13, Wednesday:

Back to work! I had a total of 8 (week)days off work, and 12 total days. This was a good amount for the surgery I had done. Had I had both legs done, I would certainly have been out at LEAST two weeks, probably more. I can’t imagine trying to walk around and be productive while hindered by two busted legs. One was annoying enough, but manageable.

While my doctor released me to go back to work, I was on “light duty” and unable to drive because my driving leg was the injured one. Oh well, I was lucky to have a chauffer (my sweet Mangosquash) for the next week!

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Work sucked. Flat out awful. It was difficult to get around with my two crutches, my leg wasn’t used to not being propped up and got super swollen causing more pain, I wasn’t in the work mindset (who is after almost two weeks off?), not to mention it was the end of the first quarter, and I had a stupid amount of work to do in the following two weeks. I felt awful, overwhelmed, annoyed, and generally cranky. I pathetically called Mangosquash at about 3 to pleaaaaseeee come get me. He obliged, being the wonderful man he is.

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My leg was so swollen and painful, I think I cried when I got home. Much icing was done and many pain pills were consumed and to bed I went.

Day 14, 15, 16, 17:

My second and third day back to work went better than the first. I weaned myself onto one crutch and was getting around easier, and was walking almost normally.

Two of my college BFFS arrived Friday night to visit for the weekend! They had never been to St. Louis before. We walked around the Arch grounds, did the Budweiser tour, and visited the City Museum. Yes, I did all those things on crutches, minus the City Museum, which was my debut to the crutch-free world! I took it easy and popped a few pain pills beforehand so I could fully enjoy it.

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I woke up with some swelling and stiffness but nothing too bad. Maybe a 3.5 or 4/10. This was the first time I really felt like a productive member of society again.

Day 19, Tuesday:

My PT was pretty concerned with the extreme swelling I was having; she said that this much swelling wasn’t typical. She suggested a medical-grade compression sock (yep, like an old person). I called my doctor up and went in to see him that day. He said “yup!” and wrote me a script for some socks and another for a NSAID.

The socks definitely add a stylish touch to my spring outfits.

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On a brighter note, officially crutch-free! And I was released to resume full duty at work!

April 10, almost 5 weeks post-surgery:

Doctors appointment. Everything is healing well! He tells me I should get another month of PT, which I agree; I’m still so weak and stiff. I’m walking comfortably at this point and doing things with minimal difficulty. The socks were working extremely well; I was having minimal swelling, and my tingling was diminishing greatly.

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April 13:

I RAN! I was slow and walked a lot and rescued a dog (seriously, a tiny shih tzu was walking around a playground alone), but I RAN! And my leg didn’t even hurt! In fact, my left leg hurt more than my right! I went almost 1.5 miles, I’d say about half was a run. My pace while running was about 15 min/mile. I’m fine with that. I cried while running. It felt so gooooood and I was so proud of myself.  I solemnly swear to never take advantage of my working body again!

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Today, April 21:

I ran once more last week while walking the dog. Again, it was super slow, but I’m counting the small victories here.

I got my measurements re-taken at PT last Friday. They are almost exactly the same as my left foot! My ankle measured at +2 degrees, as opposed to -10 at my first appointment. Still feeling super still at times and I have to stretch a lot. It feels like I have a slight pulled calf muscle, and I’m still having some slight shooting tingly pains if I touch the area between my incisions. In general, I am feeling good and walking normal and really forget I even had surgery most of the time.

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I do, however, still have a bunch of numbness around my lower scar and around the big toe area. It’s coming back slowly. I’m coming back slowly. And I’ll be better than before.

 

What the f*!$ is wrong with your leg? Part 1

Wow, what a great question. I have been asking myself that for about 6 months, since exactly September 20th. In my right leg, I have this wonderful happening called “chronic exertional compartment syndrome”. Lucky for me, it only affects 2 of 4 muscle compartments in my right leg, and none in my left. Most folks get it in both legs in all 4 compartments- YEOWCH.

CECS is a delightful syndrome that occurs most often while running/skiing/roller skating/other high-impact sports. For me, it started while I was running. I had been running since the New Year (2013) as the one resolution I actually stuck to. I was in the middle of training for a 5k, 10k, and half-marathon relay (just about 6.5 miles), and went out for a short run. Less than 5 minutes in, I got this terrible pain in my lower shin that felt like a pulled muscle. “What an odd place for a pulled muscle!” I said to myself. Then I looked down and saw that it was BULGING OUT OF MY LEG. Later I learned this is called a herniated muscle (yes, I’m basically a doctor after all my medical visits). I stopped running and the pain stopped almost immediately. Huh. I started back up, and so did the pain. What a dumb thing. I’d only run a half mile. I gave myself a week off and then tried to run again a week later while in Michigan for our anniversary. All i wanted was a beautiful 5-mile run on the lakefront! Is that so much to ask?!?!?!?!? YES. IT WAS.

Moving forward, I went to my PCP and she suggested CECS. She sent me to an orthopedic surgeon in Mercy Hospital. SURGEON?!?!?! THIS ESCALATED QUICKLY. I THOUGHT IT WAS A PULLED MUSCLE! Nah, that’d be too easy. If there’s one thing I learned in my life when it comes to my health, is that I am never lucky. The stomach flu that went around this winter? Yup. I got it twice.

Mr. Surgeon sends me for an MRI and X-rays just to rule out fun stuff like stress fractures. Again, that would have been too easy, and it wasn’t that, but he put me in a boot for 3 weeks anyway to see what happened (spoiler alert: nothing happened.). So I was told to take a month off running and then return to it slowly and see what happened.

Guess what?! The pain was still there. In January I called him and said “Yo doc, this isn’t going anywhere. Can I get that awful needle pressure test already?” and he said, “….sure… I need to find a place for you to do it first…. I’ll call ya.” He also used this opportunity to tell me that CECS is pretty uncommon, and was most prominent in young (me!) female (me!) runners (also me!). How delightful. He called me later that week when he found a place. Horray! And I could get the test done on Valentine’s Day. Excellent! Because nothing screams romance more than 4-inch long needles and forcing yourself to run until it hurts.

Getting a compartment pressure test might be on my list of top-10 things I would never wish upon my worst enemy. Maybe. It sucked, that’s for sure. FIRST- they make you wait in the waiting room for 50 minutes past your scheduled appointment (oh? that’s not part of it? just me? I digress.). THEN- they put some numbing agents in your muscles with baby needles so the big papa needles don’t hurt as much. Next, they take the “before” pressure readings. Normal pressures for un-aggravated muscle compartments are around 15-20ppi I was told. Mine were 19, 19, 20, and 21.

Finally, the fun part comes- RUNNING! What once was my favorite activity was now my worst enemy. He put me on a treadmill (which, by the way, are the worst. hate treadmills.) at an incline and told me to run until it was an 8/10 on the pain scale. Shit! Well, I was extremely out of shape by this point, having run only 2 or 3 times in 5 months. I got tired after about a mile, before I got to my 8/10 pain. That would have to do, he said.

Lucky for me, my pressure readings were high enough to be conclusive. My anterior and lateral compartments were 46 and 43 respectively! Anything over 30 they consider CECS. Wonderful (or something).

So my orthopedic surgeon calls me the following Tuesday and says “Hey Lydia! Want to come in March 7 to get your fascia sliced open?” and i said “Abso-f***ing-lutely.” at this point in writing my blog post, I have realized I haven’t even told you what chronic exertional compartment syndrome exactly is. Have I mentioned I have ADHD? 🙂

CECS is, according to the Academy of Orthopedic Surgeons, “a painful condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.” Basically, when I run, my muscles swell in those 2 compartments, and the fascia that covers and protects the muscle doesn’t stretch enough to let them swell like they want to. This pinches my nerves and blood vessels and stuff and causes the pain! So, to fix CECS, they go in and cut the fascia on the affected compartments from ankle to knee to allow the muscles to swell. Phew, now you know. Back to my story, how rude of you to interrupt!

March 7. Surgery day. My parents came in town to take care of me and give moral support to my wonderful husband, mangosquash. We all drive to the surgery center and go in the entrance on the second floor of the parking ramp, like they told us. i approach the desk and say “hello! I have a 10:30 appointment with Dr. Irvine?” and she said “…he doesn’t work in this office anymore.” WHAT! “excuse me? i am supposed to have surgery with him today at 10:30! i was told to come here!” “oh, the surgery center is on the 1st floor. take the elevator down.” Don’t worry, my luck isn’t THAT bad.

So I got signed in, pay the amount due (insert happy-dance for being double insured), read a Pure Michigan magazine, took some selfies with my mom, walked around the office a few times, and finally I got called back. I was given a locker for my belongings, a very stylish hospital gown, booties, a hairnet, and a pee cup to make sure I wasn’t pregnant (surprise: not pregnant). Then I climb in my hospital bed, get hooked up to an IV, kiss my family goodbye and off I am wheeled!

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Selfies with Mom are the best.

 

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Pre-op with a thermometer on my forehead.

Surgery lasted about an hour, which was great, because my poor family had been sitting there for 3 hours already. Side note: this is a good place for me to talk about my darling husband. He is the kindest, funniest, most patient and wonderful man, and I am so beyond lucky he loves me. Luckily I’m still head over heels in love with him when I’m high; I was chatting the nurses ear off that was wheeling me to recovery nearly in tears about how good of a Dad he will be and how sweet he is and how happy I am that he always does the dishes. She called me out on it later when I was teasing him about something, saying “Hey! You be nice to him! Weren’t you just singing his praises?”.

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Post-op with my lovely nurse, Annie.

Once out of my groggy state, I woke up famished (hello, hadn’t eaten in like 18 hours), thirsty, and in 5/10 pain. She brought me a 7up (even though I had given it up for Lent. Forgive me, Father, for I have sinned), some CheezIts, and my new best friend, Percocet. I swear, you don’t need to call NA for me, but man. Percocet. I get the appeal. I really do. Kills the pain, makes you happy, gets you through it. Unfortunately, it kept me from sleeping well. I would lay awake for HOURS in some sort of in-between state. I thought the craziest things during these times; I might have cured world hunger, mentally organized my basement, and figured out what I’m naming all my kids.

They discharged me after an hour or so of recovery with a script for Percy (the Percocet, told you he was my new BFF) and some antibiotics. My sweet mangosquash ran in to Target for me while I laid in the car and thought about my life. It’s a weird moment to think “It’s a Friday, I’m not at work, I’m so close to my work right now, what if someone sees me?” And then realize, “oh yea, I just had MY LEG SLICED OPEN, I don’t have to work for 2 weeks.” Excellent. A vacation of sorts. Take me home, Percy!

My parents were the greatest that weekend (ok and always). My mother stocked our fridge and pantry, did our laundry, cleaned our kitchen, bought us toilet paper, and washed my hair for me when I couldn’t shower. She has a true servant’s heart and I can only hope to be half as great a mother as she is. My father was a huge help also, with keeping mangosquash company and buying us some new patio chairs. We were so lucky that it was 75 degrees in early March that I hobbled outside to catch some rays (and catch them I did- I ended up with sunburn). I was so sad to see my parents leave Sunday but so ready to get on with my recovery and back to running.

Part 2 is coming soon and will detail my recovery. Sorry this is so boring, but it’s something I want to document. While going through the process of getting my surgery finalized, I read tons of CECS recovery blogs and found them extremely helpful. Hopefully this brings somebody the same comfort I received from other blogs. No! You are not alone! Yes! It sucks! But it gets better!