Thursday, July 25, 2013

4 months post surgery - a 2 mile run today!

My foot has gotten much better over the last month. In fact, I've been ready to run for 3 weeks but holding back. Instead, I've been walking fast between 4-8 miles per day. Last week, I obtained my new orthotics from Soris Tribino. They move my foot to a neutral position and I noticed how comfortable they were immediately when I started walking.  These made me feel like I could run pain free. I knew when I got the orthotics last week how helpful they are to my surgically prepared foot and that it wouldn't be long before running.
Today, I ran 2.14 miles (the lower loop in Central Park plus a little more) at an 8:34 pace, avg heart rate 170 (but was 182 at the end when I was running in the low 7s). Felt awesome to be running again. Zero pain. I decided to run at a pace where I felt comfortable and it wasn't too hard. I was surprised that it was in the mid 8s.  I'm still getting over a cold and am on antibiotics and definitely felt it while running (felt fine before). My foot position felt different on every step but I got used to it. My last run (a half marathon), I had pain on every step. Today, after the surgery, no pain on any step (even the screws). I had my first runners high in 4 months (surgery was 4 months ago tomorrow). The doctor said it would take me a year to run, and even then I would have pain.
I plan on easing back into running slowly. My standing work station definitely has helped my recovery, as has my diet (plant based).
I am extremely encouraged by my run today. Plus the blood clot in my right calf didn't bother me at all during the run, so hopefully it is dissolving!

Saturday, June 29, 2013

3 months post surgery

June 27, 2013

Just saw my foot/ankle surgeon. He said I'm 6-8 months ahead of schedule (I had the surgery done 3 months ago yesterday and they originally said it would take me 1 year to recover). I'm going to have the 2 screws in my heel removed at the end of July. Recovery from that is 12 days in a boot. I've been walking to and from work everyday (1.7 miles each way) with minimal pain. He said my tendon strength is super high. He said "wow!!" when he tested me.  Now I need to get rid of this pesky blood clot in my right calf. He said I will likely run in 3 months, maybe a little earlier. Awesome!

Still have pain in my foot but it usually is a 1-2 in the morning and a 3-4 at the end of the day. Staying active to keep it from getting stiff is key. I have moved back to my standing workstation which has also helped my recovery and I get my new orthotics made by Soris on 7/18. Excited for that. 

Monday, June 10, 2013

11 weeks post surgery

Here's a brief summary of my surgery since I last posted after developing 2 blood clots in my right calf 5 weeks post surgery.

Overall - I'm happy with my progress thus far.  The pain levels are much higher than I expected and the two blood clots in my right calf are unfortunate and often tender/painful.  I started putting pressure on my leg during weeks 7 (50%) and 8 (67%) with crutches (I was non-weight bearing for the first 6 weeks).  I ditched the crutches during weeks 9 and 10, where I put full pressure on my boot.  By the end of week 10, I was ready to get out of the boot and was cleared to walk around with an aircast only.  I had my first physical therapy appointment during week 10 and he said that my ankle was very stable and barely swollen (helped by the very tight foot to knee compression socks I was wearing), so he said I didn't need the aircast anymore.  YES!  Freedom.

I started walking regularly and this was tough.  Having my heel chopped off and re-attached with two screws means that I need to learn how to walk again, and I particularly notice that my foot steps differently now.  My arch is flatter and I now step evenly on the ground vs landing on my right side of my foot previously.  I have been having pain in every step as I now land on my big toe/the toe next to it more (right foot).  Feels like I never used the muscles to step this way and also that the pain is getting a little better most day.    Pain every step, better in the morning, really bad a night.  My PT cleared me to swim and bike, so I did so for the next 4 days following my first appointment and had no pain during either activity (although I've lost all of my fitness after not exercising for 10 weeks).  The only pain I had was while biking, where my blood clots were very sore/tender.  I really hope they go away soon.

I tested positive for a gene mutation and saw a hematologist a few weeks ago.  She drew about 20 tubes of blood looking for other mutations, so we'll see how that turns out.  She said that the mutation alone (MTHFR, homozygous for the C677T variant) wouldn't lead to taking blood thinners long term, but she said that my inflammatory bowel disease (Crohn's Disease and Ulcerative colitis) may mean that I need to take blood thinners for life.  FOR LIFE.  Great.  All kidding aside, if I need to take them for life I will.  Apparently the biggest risk for a blood clot is having had a blood clot in the past, followed by certain pre-disposed blood conditions (most of mine were negative), then other factors, of which inflammatory bowel disease is one of.  The doctor says that my kids and my family members need to get tested for MTHFR also, which can lead to a number of maladies, including coronary artery disease.

Today - I'm 11 weeks post surgery and doing well.  I had my second physical therapy appointment today and it went well.  He worked on my scars to try and flush them out (painful) and also pulled on my foot/ankle to loosen it up (very painful)!  He added more exercises and had me walk backward on the treadmill.  I had no pain doing this.  He was pleased and said that I am very far ahead of where he expected me to be.  Good news.  He is trying to temper me from doing too much too fast.  I will ease in.

The two screws have been very painful and I can't wait to get them out, which probably won't happen for 4-6 weeks.  When I have them taken out, I need to go back in a boot for 6 weeks to let the bone grow back into the holes left by the screws and avoid a stress fracture.  Not excited about being in a boot 6 weeks, but given that I always feel the screws and that it is painful to put my heel down, I know it is the right thing to do.  My heel is so painful that you can see bruises on my heel where the two screws are.  Crazy.

I've tried to stay positive and set a goal of getting a little better everyday, which I've done with the exception of a few days.

Sunday, June 2, 2013

Making a green machine

Here is a video I took while making a green machine. Nowadays, I usually add a lot of spinach, a little kiwi, mango, mushrooms, and collard greens too.

Tuesday, May 7, 2013

Post Surgery Complication - 2 blood clots in my calf 5.5 weeks after surgery

Today is 6 weeks post surgery! Hope to start walking tomorrow.

Earlier last week (Tuesday), I noticed that my right calf (same leg as the surgery) felt sore. It felt like a pulled muscle. I figured it was due to my scooting around on one leg, but it seemed weird to me given that I wasn't putting any pressure on the foot. I noticed that it was a little tender to the touch and hurt to extend my leg fully. The pain/tenderness worsened over the next few days, so on Thursday I did a quick Internet search for my symptoms and the word blood clot came up all over the place.

So, on Friday morning (5-3-13) I called my doctor and he said come in. He examined me and said that I had a mild virus/sinus infection and ordered a sonogram of my right leg to rule out a blood clot.

The sonogram started off well with the technologist saying that the popliteal and femoral veins in my right leg all looked good. Good news, I thought, those are the worst veins to have a clot in because they are bigger and deeper and can therefore harbor large clots that could potentially break off and travel to the lungs to cause a pulmonary embolism ("PE"). People die from PEs. As the tech continued, I noticed that she was stuck looking in one area. I asked "is everything ok" and she said "umm, no" and explained that I had a fully obstructing blood clot in my gastroc niemius vein. That was causing my pain/tenderness. I told them that I also felt short of breath, so they whisked me into another room to do a cat scan of my lungs with iodine contrast (I hate the hot feeling in my throat and body it gives me). Thankfully, the test result was normal and I didn't have a PE.

Later in the day I saw a vascular surgeon (Liz Harrington) and they retested the sonogram and that test showed that I actually have 2 blood clots - one in the gastroc niemius and another one in the soleus vein. Big time bummer. I am really luckily I had the symptoms and saw the doctors. The vascular surgeon ordered a blood thinner (really a blood anti coagulant) called Lovenox twice a day for 5 days (90 mgs each injection). I give myself a needle shot subcutaneously in my stomach. All 4 of my doctors (Saha, Elliott, Ghodsi, and Harrington) all agreed with me going in Lovenox. The needle/shots don't bother me. I see the vascular surgeon today (5-7-13) to see if the blood clots have progressed (I feel pain/tenderness in my right hamstring that started yesterday) and to discuss what medication I need to continue.

Also saw my cardiologist yesterday (5-6-13) and my EKG and echo cardiogram were normal.

My leg still is tender and often my foot is a light blue color (hard to see in the pictures below but I have attached a few below along with some other pictures).

The doctors say my knee walking scooter had nothing to do with my clots because I'm much more active on it, keeping the blood circulation going, but I'm skeptical.

See the foot surgeon tomorrow. Today is 6 weeks after the surgery. Hopefully he will give me the green light to start putting pressure on my right foot and to walk in the boot. I haven't put any pressure on the foot for 6 weeks

The blood clots are where I am pointing in one of the pictures. Also, look at the huge discrepancy between my left and right calf after 6 weeks of (1) no weight on the right and (2) double duty of my left calf.

Tuesday, April 30, 2013

5 weeks post surgery

I continue to get a little better, although my foot is still fairly swollen.  I'm excited for my appointment with Dr. Elliot next Wednesday (5/8), which will be 6 weeks post surgery.  Hopefully, he will clear me to put pressure on my foot!

The nerves in my foot/ankle/knee area have been bothering me (sometimes the pain level is 8-9), so the doctor prescribed me Lyrica, which helps nerve pain.  It makes me drowzy, so I only take it at night, but it seems to be helping.

This is the way my kids view me right now:

My daughter Kaiya (4) and me scooting down the street

Wednesday, April 24, 2013

4 weeks post surgery

4 weeks after the surgery I have been getting a little better every day. I've had more pain than I expected in my foot, ankle, and leg, but the swelling seems to be going down gradually. I see the doctor in 2 weeks and hope to get the clearance to put pressure/walk on my right leg for the first time since the surgery. My right shin is sore from the knee walking scooter, but manageable. Without my scooter, I would be completely immobile and likely miserable.

I went back to work about 2 weeks ago and have scooted to and from work everyday (about 1.7 miles each way). Haven't gotten on the subway once, which is always my goal, as walking (which I do when healthy) is always healthier than riding. Scooting to work is a real workout and tough because the NYC roads between 66th and West End Avenue and Times Square and 43rd street are rough, uneven, and full of potholes. I haven't fallen yet because I'm really careful, but almost twice. I usually take 8th avenue. On the way home, I use the bike lane, which is usually open and therefore lets me get some speed. Last week when I was waiting for a light at 43rd and 8th on the way to work, some guy said to me "you're moving!" I thought "huh, how does he know that?" He saw my puzzled look and said "I saw you on the upper west side about 30 minutes ago". Small world.

Wednesday, April 17, 2013

3 weeks post surgery - still not allowed to bear weight on my right leg

Feeling better everyday. Foot still very swollen and sore, including most of the way up my leg along the peroneal longus tendon almost to the knee. I've included pictures here. Pain levels are lower too.

I'm very excited that I have made it 3 weeks! Only 3 more weeks of non bearing weight. The weather has been in the 60s and 70s with low humidity, perfect running weather. It is pretty tough for me not to go running, but I'm ok. Really.

Made an appointment for my first physical therapy session for June 4th (which would be 2 months and 1 week after my surgery).

I have been stretching my tendons every night as the doctor prescribed, inverting and ex-verting the foot. I've noticed that my mobility seems limited , about the same as before the surgery. I really have a tough time extending my foot outward (to the right). I have much more flexibility moving my foot to the the middle (inwards).

I have been in my boot for about 23 hours a day. Sometimes at night I take off the boot because it is still pretty painful at night. Taking it off seems to help.

My shin pain from my knee walker scooter is better but not gone. I've been scooting to and from work, about 1.7 miles each way. Great exercise for sure, I'm usually sweating a lot by the time I'm done scooting. When it gets warmer I'll need to bring a change of clothes.

My friend Jarrod stopped by today, which was great. We enjoyed catching up and my daughter Kaiya (4) really really enjoyed playing with Jarrod (see attached pictures). My friend Shane sent me a 700 page book by Bill Simmons called "The Book of Basketball" that I'm really enjoying.

I'm am deeply saddened by the bombs that hurt/killed so many people at the Boston marathon. Many people are doing runs in honor of those the were killed/injured. I wish I could do the same for them.

Thursday, April 11, 2013

2 weeks post surgery - first scheduled doctor's appointment after thesurgery

I saw Dr. Elliot today, my first scheduled follow up after my surgery (3-26-13). 2 weeks and 2 days later.

First, they cut off the my cast and then took 3 X-rays (see the attached pictures). The swelling looked pretty good given the surgery was two weeks ago everybody said.

Next, they cut off the stitches, cleaned the foot area, and put on small band-aid looking strips, which they said to leave on a week.

Next, Dr. Elliot examined the foot. He said that I will now be in a boot vs a cast and should not put any weight on it for the next 4 weeks. He said that I can sit down on a chair in the shower and can put my foot down on the ground to let the foot sit. Overall, he wants me to have the foot sit in the hanging position now vs. elevating it (unless in a lot of pain, then I can elevate it to relieve the pain). I still have a fair amount of pain in the foot, which he said is to be expected. My pain is worse before bed and I take pain medication when needed. He also wants me to rotate my foot in and out a little bit everyday to stretch the tendon. Overall, he said that I should be in the boot 23.5 hours a day for the next 4 weeks with no weight bearing activities.

I'm getting a little better everyday and I'm excited about that. The last 2 weeks have been much tougher than I thought they would be, but I know I did the right thing by having the surgery, as Dr. Elliot has pointed out a few times.

I asked the doctor about when I can expect to so some endurance events. He thought a year or 18 months to a marathon and that waking the NYC marathon in November (7 months) is extremely ambitious and 26.2 miles is
a long way".

I also asked him if I would be able to walk some 3-5 mile races so I can get my 9 races in to qualify for the 2014 NYC marathon. He thought I would be able to start doing this in July/August.

Check out the pictures below from today. I was particularly surprised at the size of the screws in my heel used to fuse my heel back together after the doctor broke the heel and moved it over (he said he used an electric saw to break it). Crazy. He said that it is likely that I will need to have the screws removed because I will likely be able to feel them when walking/running. I can probably have them removed in 4 months, which would be the end of July. I think I can feel the screws now.

The "scooter" I use to get around is absolutely critical for me. I love it and don't know what I would do without it. I've been scooting all over the place. Today, I scooted from my apartment (66th and West End) to my doctor's office (72nd btw 1st and York), about 2.2 miles, and back home. Well over 5 miles overall. This is definitely good exercise and my glutes are getting serious exercise. Hopefully this will benefit my running in the future!!! :-)

Going back to work tomorrow (4-12) after 2.5 weeks off.
A few videos of my foot/ankle from today:
Dr. Elliot said that physical therapy will start in 2 months, twice a week to seat out.