Grad school. Amirite? I just finished my spring semester, summer starts in a month.

Several people I talked to after getting a diagnosis of Compartment Syndrome said to me “well, you can still bike” or swim, or walk, or lift weights. Some variation of that. And it was true. I could still do those things, but I didn’t want to.

Psychologically, the diagnosis devastated me. I wanted to run, I wanted to enjoy it, I wanted to be good at it. Even if I couldn’t be good at it, or enjoy it, before the diagnosis I could at the very least still do it. But then I was told I couldn’t.

I’ve been told I couldn’t do things in the past and that only made me try harder,  but this was different. A doctor was giving me compelling evidence that my continuing to run was going to cause long-term damage.

I developed a kind of isolated depression, one that only had to do with exercise. Not just running, but all exercise. I was told I couldn’t do the one thing that I wanted to do, therefore, I wanted to do nothing at all.

While the rest of my life was going wonderfully, there was this nagging disappointment in myself and my body because I couldn’t run. My self-esteem suffered, my weight increased and my self-esteem suffered some more.

I did my last triathlon July 31, 2011. My last 5k November 5, 2011. I had my surgery on November 30, 2012. In the year between my last race and my surgery, I gained 25 pounds.

Most people don’t realize I gained the weight. I look slightly heavier, but mostly muscle turned to fat and things just got loose, if you know what I mean. But during that time I got very unhappy about my body. I stopped loving my body and started hating it. I was covering it up, buying pants with elastic waist bands and feeling really sorry for myself. My upcoming wedding was what finally moved me to have the surgery. I figured I could be fat for my wedding, or I could have scars. I decided scars would be better.

I remember telling a classmate of mine a year or so ago to give herself a break. She was criticizing herself for eating McDonald’s for lunch. I told her to let it go. We are busy people, she is a grad student, she has kids, a husband,  a job. Sometimes we can’t get to the gym every day, sometimes the wrong foods sound right, sometimes we will make unhealthy decisions. But we need to give ourselves a break. So you have a bad day, then aim for a better week, or month, or in my case, year.

I found that I was giving advice to others that I needed to take for myself. I may not be a runner, even after this surgery, I may not be. I’m still living in the unknown area of whether or not this surgery was even a success. But I can still be healthy, I can still choose to exercise and I can still choose to forgive myself for not being a runner, if it turns out I’m not. I’m still so many other things.

As a side note, I think I have managed to turn comments off on all posts now. If not, I’m working on it and plan to do it soon. I’m not able to comment on blogs, I can only read from my reader when I am at work. I don’t have time to comment on other blogs and I don’t have time to really respond to comments on my blog (it’s not you, it’s me, you look very pretty today). To be fair to my readers, I shouldn’t invite comments when I can’t interact and be part of the conversation. I’m still always available by email (adnoreiram@gmail.com) if you want to talk, I happily respond to emails.

It will be one month tomorrow that I was given the ok to start running again. I had a goal of working out for 30 days straight, but I failed. I missed a total of 7 days in the month, but to my credit a couple of days I worked out twice. So there.

This is our home gym. I mean, really, with a set up like this right in my own house, there is no excuse for not working out.

I also told myself I wouldn’t set any distance, speed or weight loss goals for the first 30 days. I wanted to use that time to just sort of see how it went. I did start the couch to 5k program again from the beginning (well, ok, I skipped week 1 and went straight to week 2) because I knew without a plan, I’d likely push myself to far too fast. I would have injured my body and my self-esteem, and trust me, they have both been through enough in the last year or so.

I’ve been doing well. The first couple of weeks of running I was dealing with some swelling in the foot that I had problems with right after surgery. That seems to have gone away now. I have also had what feels like plantar fasciitis on the bottom of my left foot, except the pain that typically is felt by the heel is instead behind the pad of my foot. I’m not sure what to make of it, but it makes running for more than 3 or 4 minutes uncomfortable.

I’m focusing a lot more on strength training now than I ever did before. At most I would spend 15 minutes doing core work after a bike or run before surgery  now, there are days when all I do is strength training, in fact, I’d say I do strength training more than running right now.

Last night I did two 8 minute intervals of running. It’s the longest amount of time I’ve run since getting back to it and it is the first time since getting back to it that I had the same foot pain as before surgery.

Womp. Womp.

I’m going to assume it was just a case of my body getting used to running for a longer amount of time. Next run will be better. It will. I hope.

I officially weigh myself tomorrow and make note of my BMI. I did step on the scale yesterday for the first time since I started running again and I was down 4lbs.

Goals for the next 30 days:

• lose 5 more pounds
• run for 20 minutes without pain
• do 30 minutes or more of strength training at least 4 days each week

Things I promise not to do in the next 30 days:

• sign up for any races
• quit
• beat myself up

Amazingly, at the 6 week check up, my surgeon told me I could run. I couldn’t believe it when he said it. I was so glad Chris came along to the appointment because I know he would have never believed me if I came home and told him I was released to run.

He really gave me no restrictions, he just told me to run “as tolerated” and that since I just walked for 30 minutes on the treadmill the night before, he thought starting with a 5 minute run and 25 minute walk would be a good. He wants me to do that for a week, then increase to 10 minutes of running for a week, and so on.

Yeah, right.

So Friday night after work I went to the running store. I have needed new running shoes, but haven’t bothered to get any since I wasn’t supposed to be able to run until March. No need having new kicks sitting around the house giving me ideas.

I ended up with Saucony again, the same shoes I’ve been in since I started running. But I did try on some Mizunos and Asics, they just weren’t my shoe.

So, with new running shoes I was ready to give it a shot.

Since I had done a couple of workouts already, I was nervous. One night when I was doing the Barre workout I felt some pressure in my foot and my first thought was “oh no, the surgery didn’t work.” It was in the back of my mind that this first run could be a disaster. It was also in the back of my mind that I would be too out of shape to run long enough to even know if there was a problem.

I got on the treadmill Saturday afternoon and fired up an old quick workout that I had programmed in.

Warm up 3 minutes

Run 4.8mph 8 minutes

Walk 3.5mph 2 minutes

Repeat three times

Cool down 3 minutes

It seemed easy enough to start with, and going into it, I figured I would do the first 8 minute run, for as long as I could, hoping to make it 8 minutes, and then I’d walk the rest.

I ended up doing two of the 8 minute runs and then walking the rest. So I did more than I planned on doing, but not as much as I used to be able to do considering this was a really conservative workout that I did in an attempt to try to maintain my fitness before while not causing further damage to my feet.

Still, I was able to run for 8 consecutive minutes, twice, with no pain. No pain. None. I did feel some pressure in the foot that I had some problems with swelling right after surgery, but it was pressure, not pain.

Being able to run a few minutes longer than that would have told me without a doubt that the surgery worked, but typically I would have started having problems with my feet by 8 minutes into a run, so I’m tentatively optimistic about this.

After the run I rewarded myself with a spoonful of peanut butter, just like in the good ol’ days.

I’m going to focus my first month on recovery, and increasing my endurance. I’m not setting any goals for distance or weight loss, I just want to do what I can do, give my body a chance to adjust and focus more on making sure I get a run in 4-5 times a week.

After a month, I’ll up the anty and start looking at my weight loss and distance goals and maybe, just maybe, start looking for some races.

I’m back baby!

Not bad, really. I expected it would only get better from there. Silly me. So, a month after surgery, my legs looked like this:

You see, there were some issues. It started with me overdoing it right after surgery, which I explained in the last post. One of my feet swelled to approximately twice the size it normally is. I’m still kicking myself for not taking pictures of my foot when it was swollen, but trust me, it was bad. Because of the swelling I had to wear compression socks. I wore them for two weeks, about a week in I started having problems. I developed a rash, some sort of allergic reaction to either the socks themselves or maybe the soap I used when I had washed them.

The reaction was pretty bad at first, hence the blisters. The blisters went away a couple of days after I stopped wearing the compression socks, but the rash and itching lasted for weeks. WEEKS. It is only starting to really go away, after a week of steroids. The moral of this story? If you have compartment release surgery, do as you are told. Rest, elevate, ice. Do not walk so much that your foot swells and you require compression socks. Just don’t do it. Sit. Rest. Do as you are told. You will not be the exception to the rule, your body will not somehow miraculously be able to tolerate this over-activity unlike any other body. Sit down.

The other thing you see in the month after pictures is the liquid bandage starting to come off. At this point I was finally able to begin to see how the scars might look. I still had some small areas that were bleeding, but mostly, the incisions were becoming scars, which really seemed like progress to me. And, finally, I am about 6 weeks out now, and here is what the scarring looks like:

Pretty good. I started using a scar lotion a couple of weeks ago. You can still see the rash, like I mentioned, this thing is not going away without a fight. I started working out, not running, but some no impact exercises and only a few times a week. I’m going very slowly. I see my surgeon again on Friday and am hoping to be released to do more activities, like swimming. I know I still can’t run for another 6 weeks, but I finally feel like I’m getting closer to moving again the way that I used to, hopefully with much less (or no) pain.

Fingers crossed.

Before surgery I had planned to throw a surprise party for Chris. His birthday was one week after my surgery. I had four of his friends from out of state coming to stay for the weekend and about 20 of our friends from in town coming on Friday night for the surprise. So 5 days after surgery I was on my feet all day at the grocery store getting supplies and at home trying to hide the supplies from Chris so the surprise didn’t get ruined. 6 days after surgery I was up baking and cleaning the house, with a ton of help from a friend. Without help I could have never pulled off the surprise, but I was still overdoing it and would pay dearly for all of this later. 7 days after surgery I was on my feet virtually all day prepping for the party and then socializing during the party. Day 8 and 9 were somewhat better but we had out of town guests staying with us so I wasn’t resting as much as I should have been.

10 days after surgery I went back to work. One of my feet was very swollen and at this point no amount of icing or elevating was reducing the swelling. I could only get my feet into two pairs of shoes, which were flat dress shoes that basically had nothing to them.

As far as pain goes in the two weeks following surgery, it was tolerable. I was no longer taking medication. I was not using crutches or anything to assist with getting around. Stairs were difficult, standing for any extended period of time was difficult. Pain was mostly isolated to sharp pain when standing after sitting down and nerve pain.

I saw one of the doctors briefly a week after surgery as one of my incisions looked questionable. Everything turned out to be fine. Other than that brief visit, I had no follow up until 2 weeks after surgery. At my two week post-op appointment, as I mentioned before, I was lectured about being too active. Aside from that, things looked pretty good. He was visibly concerned about the size of my left foot and ankle. The swelling had been pretty consistent for almost a week, and he was concerned about it. I also mentioned the nerve pain I was having, oh the nerve pain.

He prescribed compression socks, which we refer to as my ‘sexy socks’ or ‘super socks’, and those have eliminated the swelling, miraculously. He prescribed Neurontin for the nerve pain I am having, but I have decided I will not be taking that. And he told me I could start physical therapy the last week of December.

The nerve pain is something I had not expected with this surgery and is something that will be an issue for many months to come. There is a nerve which has to be avoided, in some cases moved, during this procedure. I knew this going in. My surgeon did not have any problems with this, however, there is nerve damage from the procedure that will take time to heal. Because of this, I have numbness and for lack of a better way to describe it, irritated nerve ends which make touching my skin in certain places very irritating. In addition to this, I sometimes get shooting pain that I notice mostly when I am sitting still or laying in bed.

I chose not to take the medication he prescribed for this because it does not work to help the nerves heal or regenerate, rather, it dulls the nerve pain. I’m more concerned about helping the nerves recover than the pain that I am feeling. I’ve done some research on this and I believe a combination of B12 and B7 will help with nerve recovery, so I plan to begin taking those soon. Other than that, the nerves will need time, probably months, to fully recover and feel normal again. It is a really irritating problem, but it is tolerable and hopefully temporary.

Day 14 and on:

I have been cleared to do what I feel I am capable of doing. Meaning, stairs, lifting, etc. I still cannot drive for another week. I have been released to exercise, but only recumbent biking and upper body weight lifting. I can’t swim, bike, run, or do any lower body exercising yet. I am told swimming could come soon, when the incisions have healed. Running will be no sooner than 12 weeks after surgery. So, it is my hope that at the beginning of March I can start running again.

I am not able to get down on my knees, or get down on the floor and get back up without some real difficulty (learned this trying to wrap Christmas presents). And I often have the habit of sitting with my legs beneath me when I am on the couch or getting into bed, I can’t do that, it is very painful. I am not allowed to go without some sort of compression wrap. Right now I wear compression socks all day and at night I wrap my legs with elastic bandages. I really look forward to the day when I can let me legs breathe and I don’t need to wrap them.

I see my surgeon again in 3 weeks. For now I have to try not to overdo it like I did in the first week and just let my body heal.

So to review…

Day 1: Surgery

I was pretty convinced I’d die. Having never so much as had my wisdom teeth removed I was a little more than very freaked out about the general anesthetic. I tried to convince the anesthesiologist to just give me nerve block so I could be awake, but that was a no go since I was having both legs done at once.

Total time in surgery was about 2.5 hours, which was about 2 hours longer than I expected it would take. What do I know, apparently it was more complicated than I thought. There was some trouble with my IV, I was told I have “terrible veins”, but eventually they were able to get the medication in and I went to sleep.

Some hours  later I woke up in recovery. I had a sore throat from the intubation. Otherwise, I felt good. I was wide awake and as the nurse reported to the nurses waiting for me to come upstairs “talking her [my] ear off.” As soon as I was wheeled back to my room I requested to walk. My knees hurt from being laid out in the same position for 3+ hours. They gave me a walker and I took a trip down the hallway and back. No pain at all at this point.

After some crackers and water I was out of the hospital maybe an hour after surgery. We went home, got me situated on the couch, elevated my feet and had leftover pizza for dinner.

Day 2: Day after surgery

One of the complications of surgery was that I needed to be in Chicago for class the day after. No, I did not run this by my surgeon ahead of time. I do what I want. My fiance, Chris, made sure I had a wheelchair for the weekend just in case crutches didn’t cut it. And by Sunday I would very much need that wheelchair.

We got me loaded into the car. I sat in the back seat so I could keep my legs elevated and we stopped a couple of times so I could walk a little, making sure I wasn’t getting blood clots. I got to class late, but my professor was aware I’d be there late, possibly not at all on Saturday. Before you ask, my school has a complicated and asinine requirement for attendance  I had to attend class that weekend or fail. So I went. I would have stayed home if I could have.

I had a good amount of pain on Saturday. I was given Oxycodone and Tramadol for pain. I never did take the Oxycodone. I was relying on the Tramadol, which for every day but Sunday did a decent job at controlling the pain.

I was able to bear weight on my legs, but was using crutches to ambulate. I relied on the wheelchair to get from the hotel to class and back, it was just easier than trying to walk.  For anyone having this procedure done on both legs at once, I recommend a wheelchair for the first couple of days unless you plan on doing nothing but lying around your house. Which I also recommend.

By Saturday night the pain was pretty intense. We managed to get dinner, but beyond that I was in pain and the Tramadol was making it impossible for me to stay awake.

Day 3: Sunday

Saturday night into Sunday was rough. I winced and whined whenever I had to roll over or readjust my legs. Sleeping was nearly impossible. I did manage some sleep thanks to the pain medication, it knocked me out. Sunday morning I could not bear weight on my legs. The pain was excruciating and I broke out in a cold sweat and nearly vomited just trying to get to the bathroom. I was sure I would have to miss class.

We managed to get me to class. It was obvious I was in pain and just before lunch the professor sent me home. She could see I was getting nothing out of being there. We had been icing my legs in the hotel room and we brought ice with to ice them on the car ride home as well. By the afternoon when we stopped for lunch I was able to bear some weight, I used the crutches to get into a restaurant, but it was very slow going. Standing at this point was a painful ordeal. The incisions felt like they were pulling and every time I sat down it seemed like everything tightened up only to  have to be re-stretched when I stood up again. It was no fun.

Sunday evening was the first time I was able to remove the bandages and see what the incisions looked like.

Foot Bruising

Bandage coming off for the first time

One of three incisions on each leg

incision

Two incisions on the outside of each leg, one incision on the inside of each leg

Some foot swelling and a view of the incision on the inside of the leg

All three incisions and one very bruised foot

At this point I think I was pretty satisfied with the way the incisions looked. They were about what I expected except for the black markings that made me look like some sort of crash test dummy.

I was to be off of work for one week post surgery and no driving for one month. As I mentioned, I’m two weeks post-op today, so I’m still not driving, but I was back to work this week.

More on days 4-14 in the next post.

Sexy, was a new term. It was from that point on that I realized I had good legs, pretty legs, long, lean… sexy, legs.

If you recall my last post, my legs were causing me a lot of problems. I wanted strong legs, runners legs, legs that could run a marathon. I had janky legs that hurt whenever I ran.

There was a surgical solution to this problem which I chose to ignore. Instead, I decided to quit running. But, turns out, I really missed running…

Which lead to my legs looking like this. That’s me right after surgery. I had compartment release surgery 12 days ago.

Sexy, no?

Not one to do anything half way, I had both legs done at once, and then promptly had to be in Chicago for class a mere 17 hours later, I was 4 hours late to class, but I made it.

I’m going to blog the details of surgery and recovery thus far in another post, this is your warning, there will be pictures. Don’t worry, only pictures of scars, the pictures of the inside of my leg are reserved for house guests as I only have a hard copy of them.

Blogs about compartment release surgery from those who have actually had the procedure done are what convinced me it wouldn’t be that bad and that I should go for it. So I want to make sure my experience is out there for anyone else who may be considering the procedure.

I’ve decided scars are sexy, I have six of them on my legs, so I’m really sexy now.

So anyway.

If I remember correctly I ran my first 5k in 2009. I was never a runner before that. I never called myself a runner after that. I was a person who ran. Slowly. And never very far.

And when I started it was really painful. My legs and feet hated the shock of hitting the pavement and I’d collapse after every run in so much pain thinking people could not possibly do this for fun. I started running with 3 sets of insoles in my shoes just to absorb the shock and make running tolerable, because I’m nothing if not stubborn and quitting wasn’t an option.

Eventually I was able to take the insoles out and make it through a 3 mile run without wanting to have my feet amputated. The longest distance I was ever able to run was 4.5 miles. I remember the day I did that too, the whole time I was thinking “when does this runner’s high I’ve been hearing about kick in?” It never really did. Running hurt, always, it was just a matter of how much on that particular day.

My feet hurt, my legs hurt and my knee hurt. All for unknown reasons. I was not an athlete earlier in my life; there were no old injuries that were flaring up because of my new found desire to run. And as far as I knew, I hadn’t injured myself running. I never twisted my knee or anything, it all just hurt.

But I persevered and decided after that first year of running that distance running would not be my thing so to challenge myself further I’d take up biking and swimming and become a triathlete. And so I did. I completed 2 triathlons and 1 5k last summer. But my feet, my legs and my knee, they all still hurt. A lot. I was starting to hobble around like an old lady for a couple days after a race. It wasn’t pretty and I had a feeling I was causing irreparable damage to my body.

So I made the really tough decision to stop. Stop running, stop biking, stop swimming, and allow my body time to recover. I stopped, but it never recovered. My knee continued to make grinding noises and hurt and when I finally decided this spring to start running again my legs and feet were as bad as ever.

I decided maybe it was time to see a doctor to have this all looked at. So I allowed myself this summer to get fixed up, then the fall and winter to train and next summer I’d be back at it again. I’d finally do that third triathlon and more.

Turns out I have runners knee, more specifically, my knee cap sits off to the side slightly which causes it to grind against the bone behind it when I run, go up and down stairs, etc. Physical therapy unfortunately did not help this and the surgery to fix it is not recommended since it is rarely successful. But I did learn how to tape my knee so the kneecap sits where it should and miraculously when my knee is taped just right, there’s no pain and no grinding.

But I have to walk around with tape on my knee. I have to be very precise about how it is taped or it won’t help and the tape I need to use is pricey. Still, if this were my only problem, I’d be happy with the solution, it’s not ideal, but it works.

But it’s not my only problem. Hence the needles in my leg yesterday.

A trip to a different doctor and a full repeat of my symptoms led him to believe I have Chronic Exertional Compartment Syndrome. A Google search last year led me to believe that’s what it was too. The medical definition goes like this:

In chronic exertional compartment syndrome, exercise or even repetitive muscle contraction causes the tissue pressure within a compartment to increase to an abnormally high level. But because the fascia can’t stretch, the tissues in that compartment aren’t able to expand sufficiently under the increased pressure. Imagine shaking up a soda bottle but leaving the cap on — an enormous amount of pressure builds up.

As the pressure builds up within one of your muscle compartments, with no outlet for release, nerves and blood vessels are compressed. Blood flow may then decrease, causing tissues to get inadequate amounts of oxygen-rich blood, a condition known as ischemia (is-KE-me-uh). Nerves and muscles may sustain damage.

In a nutshell, this means the compartment my muscles, nerves and blood are contained in, does not allow for those things to expand as much as they want to when I run, or jump, or do high impact exercises.

The pain is excruciating and although the problem is in my legs, the pain is worst in my feet which aren’t getting the blood and oxygen they need because it’s all constricted in my leg.

So, the needles. Yesterday I ran on a treadmill until the pain started and then continued to run until I begged the doctor to let me stop. Apparently that’s how he knew it was time to measure the pressure. I laid down, he stuck a long needle into my leg in three places and sure enough, stupid amounts of pressure had built up in my legs.

The options to fix this are shitty to say the least. I can stop running and doing high impact exercise, or I can have a surgery that involves cutting my leg open, cutting the fascia surrounding my legs muscles and stitching me back up. Then I will be off of work for 3-4 days per leg and on crutches and limited activity for 6-8 weeks, per leg. They likely wouldn’t do both at the same time because, you know, I need my legs. So it’d be 2 surgeries and a total of 12-16 weeks recovery.

For a procedure my life does not depend on. For a procedure that would allow me to do something I desperately want to do but don’t need to do. I’ve cried about it. I stubbornly refused to give up running, but the fact is I can cause permanent nerve damage by continuing to ignore this and being a stubborn brat about it.

I’ve never considered myself a runner, like I said; I’m a person who runs. Now, I’m a person who used to run.

Thus ends my running career.

The new job is great, the first week or two was hell. I was sure I’d be fired, sure I wasn’t ever going to catch on, but I wasn’t and I did and it turns out I’ve oriented faster than any new employee in this position. Go figure. Yet I still do silly things like questions my abilities.

I love the job. I love the clients that I work with and although it keeps me so much busier than I ever imagined, it was a great decision to accept the position.

I’d love to come back with big news about races I’m doing this year or healthy food I’ve been eating, but I’ve been far too busy to take pictures of my food and I’m not doing any races this year… probably.

You see, I’ve had problems with my knee since the day I decided to take up running. I know you’ll be shocked to hear that ignoring those problems has not magically made them disappear. Duh.

So I will be seeing an orpthpedist at the end of April (man, do those guys take forever to get an appointment with) and I’m anticipating that I’ll be getting a scope done on my knee. Google it, not horrible, but not super fun either. In anticipation of this, I’ve not scheduled any races. If I can run maybe a 5k in the fall, I’ll do that, but I’m not getting my hopes up.

I’m still running though, I’ve just scaled it waaaaay back. I decided to do the couch to 5k program again this time doing intervals instead of slowly trying to ramp up my endurance since I more or less have that already. It’s been good, I’m not pushing it too much, mostly just trying to remember why I loved running in the first place. It’s starting to come back to me. The pressure of training for specific events had its upsides and downsides. I won’t miss the pressure for one year, but I’m sure I’ll be back at it once I get the all clear from my doctor.

School is great, for the few of you that read for those updates. It’s grad school, so it’s hard, but it’s not nearly as hard as everyone tries to make you believe it is. My classmates seem to struggle with getting assignments done on time. I just know what I have to do and I get it done. I suppose that pretty much sums up my personality in general. I just do what needs to be done regardless of how much of a pain it is.

So the schedule is chaotic, and that’s mainly why I’ve been absent. I’m moving in with The Boyfriend. We’re slowly making the transition over the course of a month. I’ll be officially out of my place and into his place at the end of April. I cannot tell you how much stress this will relieve. I might even have time to take pictures of my food again!

Since I have no pictures of food, I’ll leave you with this. My birthday was a few weeks ago (32 years old!) and The Boyfriend took me to feed the giraffes at the zoo. So awesome, so slobbery. And then the hunted down a friend of a friend of a friend who owns a hedgehog and arranged for me to go visit with him (the hedgehog, Quill was his name {!!!!}) and hold him. I can’t even describe to you the emotions I had. I ran the gamut. It will forever be referred to as the day we coined the phrase “hedgehog face.” It looks something like this:

Ok, fine, my hedgehog face was not that pretty. This was taken after the tears dried and I got myself together.