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.

Three Weeks Out - Physical Therapy, Recovery, and Questions

Hey all, sorry it's been a while - things have been busy. Last post explained my first post-op visit and left off with me excited for my first PT appointment. I went to a nice place in the Longwood Medical Area (for non-bostonians, that probably won't resonate) where they were recommended by my surgeon due to the volume of compartment syndrome afflicted patients they receive. I was still somewhat apprehensive that I might be assigned to a physical therapist that would not have significant experience with CS, but those worries were quickly placated when I met Jerry, who seemed to know his stuff.

He explained that for another week and a half, calf/ankle stretching and some very simple calf/ankle strengthening exercises would really be the only PT I would be doing, as the legs are still healing from the trauma of surgery. At about 4 weeks post-op, he explained, is when the real physical therapy would begin, with some bicycling, and, in his words, "massaging the hell" out of my legs (I assume that, among other things, it goes to break up scar tissue).

Interestingly, a reader of this blog named Tom has mentioned that his doctor advised that he should start running as soon as he could in order to break up the scar tissue. This seems to be in direct conflict with what both my surgeon and physical therapists have advised - Namely, to absolutely not run at least for the first 6 weeks, and to err on the side of not pushing it in any activity one might find themselves in. It seems that there is obviously two things that need to happen post-op - your legs need to heal, and scar tissue needs to be broken up (obviously there are additional factors, such as strengthening, but these two seem to be the crux of this conflict) - Now I would assume there would be an optimal time where the healing of the legs would reach a point that increased efforts to break up scar tissue would not compromise the recovery - the question is when that point is. So if anyone else who has been advised by a doctor as to what point they should begin running activities (and keep in mind that in both cases 4 compartments were released on both legs) then please speak up!

As for general updates on leg ability, I now can be on my feet all day with barely any pain, although I sometimes encounter swelling late in the day, however it is not too significant. Yesterday I walked all over the city, probably a combined two or three miles, with minimal discomfort. Stairs pose no issue. My right leg is still a little behind my left leg, in that the calf is tighter and flexibility is just not as far along. But overall they are still gradually improving. Next physical therapy appointment is Wednesday, so I'll keep you guys posted.....

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....

Recovery Days 5-7 - Post-op fasciotomy - Surgery Fights Back with Swelling and Numbness

While days 1-4 went relatively peachy, 5-7 encountered myriad issues that warranted a couple calls to my surgeon's office in order to find out what constituted "normal". Moral of the story was, unless something is really fucked up, it's probably within normal variations of recovery.

The first problem arose the night of day 5. On day 4, I had accidentally knocked the inside of my right lower shin/ankle pretty hard, sending a strange sensation up my leg. I thought nothing of it, however, until numbness came on in the exact spot about 24 hours later. The numbness basically encompassed the upper half of my ankle bone, extending for a swath of about three square inches upward until one of my incisions. I knew numbness was one of the side effects of surgery, but I was under the impression that if numbness had happened, I would know right away post-surgery. This numbness, however, had taken me by surprise 5 days down the road. Worried, I called the office and spoke to a fellow. She explained that while it is somewhat unusual for the numbness to come on five days after, it's not unheard of and not too worrisome. If the numbness was actually caused by the hit to my ankle I sustained, feeling in that area could come back rather quickly, but if it had nothing to do with it and was a natural outcome of the surgery, sensation in the area could take anywhere from 4 months to a year to fully be restored. What was reassuring, however, was the doctor's assurance that the numbness in that area does not hinder recovery at all, and the numbness that doctor's worry about pertains to the foot, which thankfully so far, I do not have.

Days 6 and 7, however, brought a new challenge - moderate swelling in my right foot. Along with the numbness that I also experienced in the right lower leg, it was also apparent that my two legs were simply not recovering at the same rate, which I also found worrisome. The pain in the calf (which is what hinders one from doing strong heel to toe strikes) was strongly persisting in the right leg while quickly waning in the left. Cue another call to the fellow at the surgeon's office. She explained that the swelling in the foot is the most common and very expected, as it is the primary weight bearer, and that a combination of icing, elevation, and compression stockings would help alleviate the symptoms. And in terms of one leg recovering faster than the other, she added that it is the most common complaint from patients, and is simply natural - eventually they will catch up to each other.

I also had one more overall complaint for the doctor - It almost felt as I had regressed from Days 1-5, and I was not as comfortable on my feet nor proficient at ankle pumps as I had been earlier. Once again, the fellow dexterously assuaged all my doubts by saying that as patients feel more comfortable on their feet, they probably push their limits too far, causing the legs to stiffen up temporarily and recover.

So, what's the conclusion? First of all, that this fellow I spoke to should definitely be employed in some sort of suicide prevention program. I could have called in saying both my legs had fallen off, and she probably would have found a way to calm me down and make me feel that it was a normal process of recovery post-surgery. In all seriousness though, it made me realize that post-op recovery is not going to be a linear progression, and I need to be emotionally and physically prepared for the ups and downs that are coming. I just hope that at the end, I'll be back to where I want to be....

Days 1-4 post-op fasciotomy - Recovery Begins

For the first 4 days, everything was going alright. I was slowly able to progress from barely being able to lift my feet off the ground to being able to do some nice heel to toe strikes. On day 3, I was told that I was allowed to switch from the four-point crutch gait to the two point, which allowed for much greater mobility. Whenever I was laying down, (which I probably was 90 percent of the day), I would have my feet steeply elevated and be icing. After my second night sleeping on the first floor, I moved up to the second, and while a flight of stairs is certainly not easy, there wasn't any major problems or pain from doing it.

Starting on Day 3 -Three times a day, for about 5 minutes, I alternatively lift both legs in the air and do a couple sets of twenty ankle pumps, but quite lightly, as I was told it is important not to push anything, as the body is recuperating. By day 4, I was moving around the house without crutches, and even was able to drive to the post office to mail something. The doctor said that on walks that are longer than those one would typically take around the house, crutches should be used until day 7-8.

In terms of physical therapy, my surgeon told to me that under no circumstances should I begin any kind of PT before my post-op appointment on April 12th.
So far, no swelling or numbness to report, and I keep ace bandages on both legs tightly wrapped - Step by step, my recovery is taking shape.....

Shin Splints? Back Pain? Frustration! Part II

During the aforementioned four weeks (the time between when the numbing, tingling, pain in my shins began to cut down my runs, and when I actually went to a doctor) I began to suffer from a gradually debilitating lower back pain. It started subtly, but it got to the point, that by the end of four weeks, I couldn't even reproduce the numbing/tingling sensation in the lateral shins because my lower back was not even permitting me to run the required amount to bring on the leg symptoms!

I frantically went to two orthopedists, who, after hearing my history, concluded that I was first having shin splints, and gave me the company line that due to extremely tight hamstrings, my back was acting up. Solution? Physical Therapy for the back, and rest from running (which I could not do anyways due to the back).

Physical Therapy helped, and I got my lower back to be once again compliant with running - and then to my surprise, the symptoms in my shins came back even worse than before, along with an ever-shifting lower back pain (sometimes more lateral, sometimes down in the upper buttocks, and sometimes even closer up to the mid-back) that was bothersome, but not nearly as painful as pre-physical therapy back pain.

It was then that I decided to seek a third opinion from a back specialist, whose diagnosis has informed all my treatment since then. When I gave her my history, she stopped me at what I described as shin splints - When I told her my exact symptoms, she replied, "that sounds much more like compartment syndrome" - and then she tried to put the pieces together - This is what she theorized: When I continued to run through the CS pain, I had to alter my gait due to the lack of function of my lower leg muscles, which consequently completely threw off my biomechanics, thus aggravating my back. As my back got aggravated, I began to compensate with other muscles, thus weakening my back/core further, which required physical therapy. She suggested I get an intracompartmental test, as that is basically the only way to test for exertional compartment syndrome (unless you live near a place that is experimenting with the MRI diagnostic procedure).

That is one thing I have not seen on any site with people detailing their CS symptoms - anyone else experience any sort of back pain in conjunction with the CS?

Next: intracompartmental test - kinda sucky