Monday, March 18, 2013

Recovery Log - Monday, March 18, 2013

It's been a month since my last blog update. This is probably the longest time between blog posts ever since I started this blog over three years or 541 posts ago. It's kind of ironic, since it has also been my longest layoff from any type of physical activity.

Monday of last week marked another huge milestone in my path to full recovery, both from my ankle injury and from my blood clots (DVT and PE). Six weeks after my reconstructive ankle surgery my orthopedist finally removed the non-weight bearing ankle cast and placed me in a weight bearing ankle boot instead. That also meant I was able to "retire" my crutches and the wheel chair I had to use at work to make my way around the office. Hey, you try carrying your morning coffee and a bottle of water all while using crutches. Take it from me, it's impossible. Don't get me wrong, there were ideas for new products floating through my head, like cup holders that attached to your crutches (including some type of gyroscopic device, just to make sure the coffee wouldn't spill while walking with the crutches. Hey, I said I thought about it, not that I had it all worked out. If I did, I wouldn't have chosen to ride the wheel chair. Instead, I would be writing this blog on a tropical island somewhere while sipping Mojitos and counting the money I made of this brilliant idea.

But, it wasn't meant to be, so here I am and since the orthopedist had told me that I would be able to start PT as soon as the cast was removed, I was sitting in my PTs waiting room Tuesday morning. After a short chat, we got started on my initial therapy session, which consisted of exercises to increase the range of motion in my ankle. I also scheduled my biweekly aquatic therapy sessions, which my PT recommended for the 4 week duration of my physical therapy.

Along with the biweekly aquatic therapy I also had to complete a very mild exercise regimen twice daily that would continue to work on increasing my range of motion without putting serious stress on my ankle. By Wednesday morning 5AM I was in the pool swimming laps for the first time in over 25 years. I hadn't been in a pool to swim laps ever since High School, when students were required to get certified as rescue swimmers as part of our PE class. To say that I disliked swimming would be an understatement, but my doc and PT said that I could participate in any activity that didn't put stress on my ankle and from an endurance/aerobic activity standpoint that really only left swimming (yeah yeah, I know, there is some weird spinning contraption for upper body use that must look like an upside down bike or something, but I figured I'd stick to something I was a little more familiar with, even though I "disliked" it). I figured three lap swimming sessions per week would be much better in my quest to full recovery than no aerobic activity at all.

Now that I had sorted out my approach to aerobic rehab for the next 6 weeks until the boot would finally come off for good to allow me to start walking/running recovery, I needed to think of a way to regain some of that muscle that I'd lost over the course of 4 months. I say regain "some" muscle, because I never really had a lot of it:-) At least I wanted to try to turn some of that fat that had deposited itself around my midsection into muscle. I still can't decide what's worse for my health and fitness, my lack of running and other physical exercise or my chocolate, gummi bear and general carbohydrate addiction, but I'm starting to have a pretty good idea.

Anyway, I also started entering the weight room again to add a small 60 minute biweekly strength training routine to my recovery schedule. Obviously, it could only do seated weight exercises along with some core work while laying down, but it was still waaaay more than I had been doing. I can honestly say that even though I'm using small weights, I am pretty sore to start off this week. Regardless, it just feels great to do something, to be active again, even if it is way less than what I was used to prior to the injury and my other health woes. I take it. I don't mind taking it slow. I have no desire for an injury relapse. I am looking at it long term. Do I want to run an ultra marathon or play a soccer match next week? Heck, yes. Am I okay to wait or even dial it back a notch long term? Absolutely. Do I expect to make a full recovery? 100%...and then some.

It is very hard to believe, especially for my friends and close family, that I would be willing to do the right thing, meaning to strictly follow my "doctors' orders". If you know me, you know that I want things now. And while that might not always be a good thing or reasonable thing, I am always willing to put in the work to get there, if not now at least very quickly. But this injury has been different than other previous injuries. I was always ready to come back right away, not afraid to get hurt again, ready to jump right back into the proverbial deep end of the pool. Not this time. This time I'm worried that I'll get hurt again, worried that I'll reaggravate the ankle, worried that I'll require surgery again. Nervous that any pain that I feel as a result of my rehab and recovery could be another blood clot forming in my legs or my lungs. Worried about all the things that can go wrong.

And it's not just during or after exercise. I've had moments were I'm sitting down on my couch or were I'm laying in bed, wondering if that little pinch in my chest is another PE or where that pain in my leg really is a sore muscle or another DVT. Whether I told my wife and my son that I loved them today...just in case. To be honest, those moments scare the crap out of me and it always takes me a while to get over them.

Will I ever not have these moments? I'm not sure. I expect that they will become less and less frequent over time. In the meantime, I make sure I tell my wife and my son that I love them more often than I used to. I know it still hasn't fully sunk in just how lucky I was these few days in early December, when I was admitted to the hospital for multiple DVTs and PEs. I think it's because I was lucky to have an amazing wife that stood  (and slept) by my side the entire time I was in the hospital along with a son who got up in the middle of the night to be there with his dad during the first 48 hours that were by far the scariest for me and my entire family. Having them close by the entire time made me not worry, made me truly think that everything was going to be fine. And it was...is...fine. Maybe I haven't fully processed how close I came, but I have realized that I am very lucky to be alive and to be loved.

Sorry for rambling on in last three paragraphs. They appear to be more about my mental than my physical state and while I'm not sure how I ended up going there, I'm glad I did. Writing it down felt good. Hope to see you all soon, either on the trails or on the soccer field. It's been too long:-)

Tuesday, February 19, 2013

Medical Update - Slow Progress, But It's Progress

It's been almost 3 weeks since my last update. I am now 10 days into wearing a non-weight bearing fiber glass ankle cast and I have 18 more days to go before my sports orthopedist removes and replaces it with an air cast boot that I will be required to wear for another 6 weeks. However, I will be able to start physical therapy as soon as the cast comes off and I won't need my crutches any longer, since I will be able to somewhat walk in the boot.

I also realized that the past few months of not running or working out at all have finally caught up with me in form of weight gain, not bad but bad enough. I figured what better way to get rid of those extra pounds than to challenge one of my training buddies (that's right, Richard, it is not only Facebook-official but Blog-official, too:-) to a 4 week weight loss challenge. Winner gets a free ultra race entry.

I got another great piece of news today that will really help me with the mental aspects of my recovery. I had purchased a couple of raffle tickets to support the Special Operations Warrior Foundation, when I saw Joe Fejes (yes, the Joe Fejes, ultra runner extraordinaire and member of team USA for the 24 Hour World Championships among other things) at last months Mountain Mist 50K here in town. One of the positives of not having been able to run or race for the past few months has been the enjoyment that volunteering at races and hanging out with folks like Joe has brought me. As "fate" would have it, one of my tickets actually won one of over 80 graciously donated race entries. I received free entry into the Coyote Springs 100 Miler on November 3 in Nevada. I'm not sure yet if I can get ready in time, but I will do everything I can to do so...safely and smartly.

Oh yeah, my new "purpose" for my ultra running adventures is also off to a great start. If you're reading this, take a look to the top right column of this post. Please take a moment and click on the link, read my short story and maybe consider making a small donation. If nothing else, you might learn something that could save your life or the life or a friend or family member.

And now, back to recovery...

Friday, February 1, 2013

Medical Update - An Exciting Week Comes To A Close

It's been a couple of weeks since my last update. To be honest, I'd much rather be writing training updates, but for now these little health updates will have to do:-) An exciting weeks draws to a close.

After being admitted to Crestwood Hospital this past Monday, a temporary inferior vena cava filter was implanted on Tuesday afternoon by a vascular surgeon. On Wednesday morning, my orthopedic surgeon was finally able to repair the lower tendons in my left ankle. By Wednesday afternoon, I was released from the hospital. So what's next?

I am currently resting at home. The procedure to remove the temporary filter is tentatively scheduled for next week once I've had a chance to see my hematologist for a follow up visit. Another follow up is scheduled for the following week with my orthopedic surgeon to check on my ankle's progress, remove the staples and put my ankle in a non walking cast for approximately 4 weeks.

I am keeping my fingers crossed that this is exactly how the next couple of weeks will unfold as that would indicate my ability to start rehabilitation on my ankle by early March. I can hardly wait to get back out there and work out and just go for a walk:-)

By the way, I've had lots of time to think the last few weeks and I decided to put this energy to good use. I've created an ongoing fundraising effort (see link in upper right corner of this blog) that I will be persuing in all my future ultra running and racing adventures. Please check out the page, no strings attached, and please share. Blot clots and clotting disorders are much more common than you think and they can affect anyone, even endurance athletes, even without any predisposing factors. I learned this lesson the hard way. But there are lots of things we all can to to reduce this risk for ourselves as well as others by educating ourselves and by supporting the efforts of organizations like the National Blot Clot Alliance (NBCA) and their "STOP THE CLOT" campaign.

Wednesday, January 23, 2013

Medical Update - Finally some really good news!!!

Hopefully, I am not jinxing anything with this post. After having been on the phone this afternoon with nurses from all specialists involved, my ankle surgeon and hematologist were able to get their schedules sorted.

My hematologist is admitting me to Crestwood Hospital on Monday morning, where they will start bridging me from Coumadin to Lovenox before taking me off blood thinners altogether just in time for reconstructive ankle surgery on Wednesday morning. Prior to the ankle surgery, a specialist will insert/implant a temporary filter into my main vein to prevent any potential clots from traveling to my lungs, heart and brain during and after my surgery, since I will be off blood thinners for a short duration.

This temporary filter will be removed as soon as my INR levels are back up between 2.0-3.0, the preferred blood thinness levels for people recovering from DVTs and PEs in an outpatient surgery. Once the ankle surgery is complete, they will keep me in the hospital for another day for observation.

I expect to be on crutches for 10 days before getting my staples removed. At that time, my foot will be places in a non-walking cast for 4 weeks followed by an air cast boot for 4 additional weeks, during which I expect to start my formal physical therapy. I really hope all goes well, so I can be on my rod to full recovery very very soon. Who knows, maybe I'll be back to running by April, just in time to continue the tradition of running the Cookie Dash 5 K. Only this time, she will be pacing me. Shoot, I'll probably be lucky to walk a 5K at that time, which would still be a great improvement over the last 3 months:-)

Recovery is my main goal and I am happy to take all the time necessary to get back to actual running.

Monday, January 14, 2013

Medical Update - More Good News

My hematologist scheduled my follow up CT Scan (Angio Chest) for today to check whether the pulmonary emboli in my lungs had been significantly reduced in size or maybe even dissolved. This would allow him to contact my orthopedic surgeon to finally schedule reconstructive surgery for my ankle.