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!

Rolfing (ouch!), Physical Therapy, Stretching - Helpful for some things, but not exertional CS

I now faced a decision - Do I decide to go under the knife right away, or do I try to convince myself that with a little alteration of activity and different forms of massage, I can live with the condition? Obviously the latter is a little less daunting, so I quickly devoted myself to all forms of alternative treatment.

First up - Physical Therapy - Went about six times (Over the course of this entire saga, I did feel partly guilty for taking advantage of the fucked up healthcare system we are all so privileged with in the U.S.) The physical therapist admitted that she had not seen anyone be able to actually overcome symptoms of compartment Syndrome, but she would give it a try. She did all different sorts of ankle, shin, and calf massages/manipulations, but over the two and a half weeks that I attempted treatment, there was simply no progress, and I decided to move on.

Second - Rolfing - While I had not heard of rolfing until I read this article in the NYTimes (http://www.nytimes.com/2010/10/07/fashion/07rolfing.html), it is a treatment that many people I now know swear by. Why it interested me particularly for Compartment syndrome, though, was the fact that rolfing is completely devoted to resetting all the fascia in the body. And what do you know? Compartment Syndrome is fascially based! I went to a rolfer that came highly recommended, and while he did say that he has seen people afflicted with CS overcome the disorder through rolfing, it was not a high percentage. I decided to give it a try (and at about 125 a session, it was not an easy choice). Now, granted, I was warned beforehand by many a rolfer devotee that rolfing was painful - but nothing, I mean nothing, can prepare you for the actual experience - Plain and simple, it fucking hurts. Thankfully, though, my rolfer was laid back, and thus didn't mind me lashing out at him into my pillow with language that most would not approve of. I went to five sessions with him, and while I sometimes did see small improvements, it was never substantial enough to allow me to conclude that the rolfing did actually help. My rolfer did however explain how my back pain could be connected to the Compartment syndrome, as he showed me quite a startling picture of someone's fascia cut out of their body, and it really is ALL connected.

During both the PT and the rolfing, I also tried doing at-home stretches that I found on the internet that I thought might help, but I really did not see any marked improvements (although by this time I was also extremely discouraged). A couple weeks post-rolfing, and my CS had progressed to where I could not even play an hour game of basketball comfortably, and the daunting realization that surgery would be the only option if I wanted to continue my athletic pursuits slowly began to set in.

It was time to tuck my tail between my legs and, with my test results in my hand, consult a surgeon :(.