Ups and Downs - Running, Biking, and Some Pain in Between

Hey all, sorry I've been away for so long... The past 3 weeks have been quite scary, as my left leg has felt like the Compartment Syndrome was back and rearing its ugly head even stronger than before.  The right leg, however, has been doing swimmingly, and has felt great (Interesting, due to the fact that for the majority of my recovery, the right leg lagged behind the left - moral of the story: Recovery is a fucking roller coaster).  There would be a constant sort of burn/pain in my left outer shin/ankle, and going up steps would exacerbate it (although interestingly enough, jogging and biking kind of made it feel better?  Anyone have any idea what the that could be?)

The surgeons and physical therapists both claimed that it is simply too early to tell if what I am feeling is an indication of the compartment syndrome coming back and the fasciotomy being a failure.  I am currently about 10 weeks post-op, and they say I need another 2-3 to see where I'm at.   My physical therapist even claims it might be due to weak peroneals in my left leg.  Either way, I am happy to say that there has been a steady improvement over the last 4 days with regards to the left leg, and now the symptoms are just a sort of constant burning sensation over the left shin/ left foot area, but are not exacerbated by activity.  I sincerely hope it is just the pains of getting better, but we shall see. 

In terms of activity, I am alternating days of running about a mile and biking about 7 miles.  While running, my legs feel pretty good, although I've noticed that there is an imbalance strength wise between my right and left leg (right leg is much stronger), and thus I have been instructed to go to a chiropractor to make sure my alignment isn't out of whack and throwing off my form completely.  Appt. is on Wednesday, and hopefully I'll update everyone on what's going on.

Compartment Surgery Recovery - Elliptical Baby Steps

Got on the elliptical today and felt no pain - Granted, it was only for 5 minutes, as the physical therapists say it's important to take it slow and not aggravate things.  It was a baby step, but a significant one.  Tomorrow or Wednesday I'll ramp it up to 7, and hopefully in about a week I'll begin light jogging.

Encouraging Progress Continues....

Biked 5 miles yesterday and had absolutely no pain in the legs - Also, after identifying that I had almost completely lost all glute/hip activation while doing day-to-day activities, I have started to do certain strengthening exercises, such as X-band walking and the first two exercises detailed in this video, and my back pain has been gradually subsiding, which is awesome.

Numbness in Right Leg - Updated Good News

Also, just a quick update on the numbness I have felt in the lower inside area of my right shin, as detailed here - It has been gradually improving, and a large percentage of the numbness has dissipated. There is still a line of numbness, but it has been getting gradually smaller for the last couple of weeks, and has no effect on day to day activities.

Some Good Signs

Biked on Friday for 10 minutes - No issues, but still haven't ramped it up yet - Either way, it's progress.... Start Elliptical in a week, and running in two...I'll keep everyone posted

Updates - Recovery and Physical Therapy

Hey all, just a quick update - Have progressed to doing squats (extremely sore! In a good way though) and heel raises throughout the day pain free which is awesome - Pre-surgery those could simply not be done without the compartment syndrome high pressures stopping me ... tightness in the calf is abating more and more every day - This Monday I start bike and massage and I'll post how it feels....

2 Week Post-op visit - The Fun of Recovery Begins

With the swelling and numbness of the lower right leg somewhat subsiding, I was quite excited to go see what the surgeon had to say in terms of how my recovery was going. I also am planning on leaving the country in late May/early June, and wanted to understand if that would be detrimental to my recovery or not.

After quite a long wait (While this doctor is know as one of the best sports medicine surgeons in Boston, he also has a reputation for really shitty waiting times - Either way, I'll take that combination over the reverse any day), an awesome fellow came in to remove my stitches. I had 4 incisions on each leg, with 6 of the 8 being stitches that could dissolve on their own, and the other two being ones that had to come out. The fellow said she would also try to take as many dissolvable stitches out as my legs would let, as the rule of thumb is usually that the less foreign bodies in a person's leg the better. She got all the stitches out except for one dissolvable one, which was alright with me. As far as pain went, I've read in other places that people have experienced insane amounts of pain during stitch removal. Except for when the fellow tried to remove the one stitch that wouldn't go, there was barely any pain worth noting - she had hands of gold!

What was also good about this setup was that while taking the stitches out, the fellow was able to provide me with all sorts of reassuring information - Men do tend to fare better overall than women (sorry ladies), and she had a friend who got the procedure done a year and a half ago who is now doing triathlons. When I expressed to her concern that I had heard people who are a year and a half out of surgery and still can't go full throttle, she replied that recovery is really different for everyone, but that a substantial percentage of patients in my situation were really able to resume full activity around week 12.

Shower-wise, she said I was all good to go, except that I should only let soapy water fall down on the lower legs, and there should be no scrubbing in that area. She also recommended knee-high compression stockings in order to allow the blood to flow easier throughout the lower leg and prevent swelling. When I went to the medical supplies store, they gave me two different compression stockings to try out - Medi, and Jobst. For me, Jobst was far and away much more comfortable than the Medi, so if you have the choice, I would really recommend going with it.

Finally the surgeon came in, said my legs looked great, and said that I was all cleared to start physical therapy tomorrow. While he said the physical therapist could give me a better idea, he recommended staying for at least 6-7 weeks from the start of physical therapy in order to get the greatest benefit. I guess I'll find out more tomorrow....

Some Encouraging News - Recovery from Surgery Seems to be Back on Track

Good News! Swelling in my right foot went down dramatically over the course of yesterday (Day 11), and like magic, my right leg's ability to carry out normal walking functions vastly improved. It is still not quite up to the left leg's recovery yet, but hopefully it will continue to catch up. Also, although it might be wishful thinking, tt seems as if I am regaining some feeling in the 4 square inch swath of leg that has been lacking any sensation for the past 4-5 days.

Also, a little comically, I tried to take an actual shower 2 days ago for the first time (rather than just washing my hair in the sink - yeah, do the math, it means I didn't really wash my body for 11 days - It was an experience). I was warned not to get the incisions wet and was told garbage bags could provide the necessary protection - MAJOR MISTAKE- By the end of the shower, both legs were pretty soaked, and since I kept my ace bandages on during the shower, the incisions were to a certain extent being continually kept in water. Since it was already day 11, I hope it wasn't to damaging (and it was also a pretty quick shower), but a word of advice - If, unlike me, you need to actually be a real person during the initial 10 days of your recovery, and thus actually shower, I would recommend investing in something like this - It seems a tad expensive, and I'm sure if you look around you could find something cheaper - But really, it's not worth putting your recovery in jeopardy by screwing with your incisions, so be careful.

My first post-op appointment with the surgeon is tomorrow, and I am hoping he will tell me I can begin physical therapy - We'll see how it goes....

The Day of Reckoning - Surgery - Bilateral 4 Compartment Facsiotomy

I found it fascinating. In the weeks leading up to the surgery, I would always get asked the question, "are you nervous?". And I would reply truthfully, that I wasn't. But driving to the hospital at 2 in the afternoon on the day of surgery, it hit me. This literally would affect my entire life going onward. Either it would work, and I would be able to resume athletic activities, or it would fail, and I would be forced to significantly alter my lifestyle, as I had done for the past year. I guess relatively speaking, it wasn't nearly as big as some actual life-threatening surgeries people face every day, but still, this was important to me - and I was rattled. This was something that I absolutely could not control; I was at the mercy of my surgeon's abilities.

It was also eerie checking in alone - While that is probably normal for most adults having surgery, the last time I had any kind of procedure done with anesthesia was in 10th grade when I got my nose shattered by an elbow while playing basketball. Back then, my parents accompanied me. This time, however, I was alone. It kind of hammered in the point that this surgery was about me, and if it did fail, no amount of comfort in the world would allow me to be the same.

Alright, now on to the details that you all actually care about. My surgery was scheduled for 330, and I was told to arrive at 2. I got there, and switched into the always-oversized and forever-comical looking gown. Doctors came around periodically and almost all of them asked me the same questions about what I had eaten in the last 24 hours (I was not supposed to eat after midnight, and not supposed to drink water 2 hours before surgery). I could not tell if this was a case of unfortunate bureaucracy or if it is protocol in order to really make sure the patient isn't forgetting the entire pizza they ate an hour before surgery, I'm not sure.

I asked to see the surgeon before, as I wanted to ask some last second questions in order to have some peace of mind before they put me down. I had 2 questions - 1. I reiterated the fact that my lateral compartment was negative bilaterally in the compartment syndrome test, and wanted to make sure that, with that knowledge, he still wanted to release it, and 2. If something does go wrong, what are some of the effects I might experience (I know, stupid to be asking 15 minutes before surgery, but I'm a glutton for punishment). For question 1, he repeated the same answer he gave before, that it would not compromise recovery if the lateral compartment was released, and would benefit me in that it would reduce my chances of symptoms returning post-surgery, which would obviously suck.

For 2, he told me that failures usually entail the returning of symptoms, and in 1 case of an older women, there was some permanent numbness in the leg. Armed with these somewhat reassuring answers, I was prepared to go under. The anesthesiologist gave me an IV, started pumping the good stuff, and away we went.

Surprisingly, I woke up quite comfortably. I could feel my legs were bandaged, and there definitely was a feeling that something happened down there, but pain was kept to a minimum. My mom also appeared, as she was going to drive me home. Apparently, the surgeon said that both lateral compartments appeared quite tight, so it's good that he released them despite them coming up negative on the compartmental test! After some saltines and a bunch of water, I hobbled up with the help of a nurse, and got into the wheelchair. Then I had my first real test when I had to get out of the wheelchair and into the car. It's hard to describe the feeling, but it was somewhat similar to my calves being locked, and if I tried to use them, some serious pain would result. So I somehow managed to get in the car, and then, using crutches, made it from the car to a bed I had set up on the first floor. At this point, walking consisted of shuffling my feet using the four-point crutch gait. Any flight of stairs that had more than 3-4 steps would have been immensely uncomfortable at that point. I had a bunch of pillows piled up at the end of the aero bed I was sleeping on so my legs would be seriously elevated. I also was given these nifty ice packs connected to coolers, so I could essentially pump cold water into the packs as needed. I basically got into bed, popped 2 5 mg pills of oxycodone, and drifted in and out of sleep for the next 12 hours. Pain was definitely there, but very mild. I did need to go piss a couple times during the night., though, and the most difficult part was standing up, as that required putting more force on my legs than they allowed, but I mainly just shuffled my way back and forth using crutches.

More updates to follow!

Fasciotomy Pre-Op Appointment - Cautiously Optimistic

Finally it came to the day I was looking forward to for a couple weeks. When I got called at the office, a fellow who works with the surgeon came in to take my history, and ask if there were any problems, etc. I explained to him that over the last couple weeks I had started to feel the effects of CS even when I was not exercising, as it manifested itself in a sort of uncomfortable, not getting great circulation feeling in my legs. He explained that this was not crazy, and sometimes is how compartment syndrome progresses.

Then the surgeon came in. He explained to me that even though I had only three compartments test positive for compartment syndrome, he thought it would be best to release all 4 on each leg. I asked him the reasoning for this, and he explained his reasoning: 1. I had explained to him that most of the pain I felt during running was actually in the lateral area, and thus he thought it would be foolish to leave the compartment alone and 2. He told me that there have been lots of cases where people get 1,2, or 3 compartments released and then are symptomatic later on for the fourth and have to have surgery all over again, so it was safer to release all 4 compartments in this case.

I was worried, however, that this would make the procedure a little more risky, just from the logic that the more compartments you mess around with, the more random things can go wrong. He responded that the releasing of the lateral compartment did not significantly compromise the success of the surgery, and that the benefits of doing so far outweighed the risks.

Then, on to success rates. The doctor told me that 90% of his patients experience full recovery, meaning they are able to achieve athletic performance levels that are commensurate with how their performance levels were pre-onset of exertional compartment syndrome. While in the grand scheme of things, that is not as high as I would like, after reading the literature and looking at online forums, it unfortunately seems that that is the best you are going to get. Plus, I would like to think that since I am still relatively young, my chances will be good.

In terms of a recovery timetable, my surgeon said at 4-6 weeks I could begin to do cycling, 6-8, running, and at about 10-12, I should be nearing full recovery. While that is a substantial amount of time, I really don't care in the slightest if I will finally be able to do the things I love for the first time in a long while.

The surgeon also said he would be sending me for an MRI just to rule out vascular restriction in my legs, as apparently that sometimes causes compartment syndrome-like symptoms. With that, I thanked him profusely, and barring a rare case of vascular restriction, was set to go under the knife!