First post op follow up

I now have more empathy for my patients after my follow up yesterday with the surgeon. He deemed my leg "hypersensitive" after demonstrating how to perform a deep massage to the anterior compartment. I then cried like a baby in front of everyone. The good news? My incisions look awesome! Below are some pictures before and after they were cleaned up and the steri strips were changed.

 Distal incision before getting cleaned. 

Both incisions prior to getting cleaned; steri strips on. 

 Both incisions after getting cleaned up; new steri strips.

Smiling after getting cleaned up. This was after wiping away all the tears. 

My experience with chronic/exertional compartment syndrome and compartment release/fasciotomy

Disclaimer: Please do not use my experiences to diagnose yourself or someone else. If you think you have compartment syndrome please see your primary care provider or orthopedist.

I was starting to give up the idea of ever running again when I spoke with two of my former classmates whom suggested I may have compartment syndrome.  I immediately scheduled a follow up with my orthopedist to see if this was the case and what to do about it.

There are two forms of compartment syndrome: acute and chronic. Acute compartment syndrome normally occurs following a traumatic injury.  The injury causes swelling in the compartment.  The fascia around the compartment is not flexible and does not allow any relief of the pressure. This is a medical emergency and is treated with a fasciotomy.  This is an incision along the length of the skin and fascia to relieve the pressure. The second type of compartment syndrome is chronic or exertional compartment syndrome. This is often seen in athletes of repetitive sports (think running, cycling). There are multiple theories regarding what causes chronic or exertional compartment syndrome.  Some of these are biomechanics, tight or adhered fascia, or poor venous return. Most research shows that the best treatment for chronic exertional compartment syndrome is a fasciotomy.  However, it is recommended to try conservative treatment first (stretching, physical therapy). The fasciotomy or compartment release for chronic exertional compartment syndrome is not as invasive as that performed for acute compartment syndrome.

A diagnoses of chronic compartment syndrome is based based on history, symptoms and signs during a physical exam. My symptoms were pain in my lower leg and sometimes in my foot during the following activities: walking, running, stationary bike or cardio on the elliptical machine at the gym. If left untreated, the swelling in the compartment can cause compromise to nerves, muscles and arteries (ie.numbness, tingling, paralysis, tissue death).

A pressure compartment test is the "gold standard" for diagnosing compartment syndrome. For chronic compartment syndrome, the pressure in the compartment is taken pre and post exercise (1 minute after and then again 5 minutes after).  A large needle is stuck into the compartment and then a catheter is inserted to test the pressure.  My pressure was elevated at rest and then increased with exercise. This along with the clinical signs I exhibited confirmed my diagnosis of chronic compartment syndrome.

Since I had failed conservative treatment (physical therapy, stretching, taping, etc.), I decided to have the fasciotomy.

I am now one week post op.  The pain has been tolerable for the most part. I am now able to walk from one room to another in the apartment without crutches if my pain is managed. I am starting to wear the walking boot as that is what I will need to wear to return to work later this week.  The boot puts a lot of pressure on the incisions and I can not wear it for very long.  This is only the second day that I have tried wearing it. Initially after surgery I was put in a splint. However, I had that removed the day after surgery because it was putting too much pressure on my heel which caused pain and burning. The incisions look great (from what I can see; they are covered with steri strips) and I am just starting to have bruising throughout the front of my leg.

Below are some pictures of the incisions. If you are squeamish don't look. I don't think they are too graphic, but I work in health care and am somewhat desensitized to seeing clean, intact wounds. A word of warning: I wouldn't google image or video search "fasciotomy" unless you want to upset your stomach.  I have watched half a dozen surgeries and see post op incisions frequently at work, however some of the pictures and video that come up regarding faciotomies are quiet graphic (especially if you are thinking of having the surgery done!).  (Do keep in mind that most of them are for acute compartment syndrome and the surgery is much more invasive than that for chronic compartment syndrome.)

 Hanging out on the couch. Day of Surgery (DOS).

 Distal incision POD # 1. Taken just after getting the splint taken off.

Elevating my leg on the patio while enjoying the view.


As far as recovery goes, it will be a full 3 months until I am able to "return to sport," which for me is running. I will be able to bike and eventually do the elliptical prior to that 3 month mark. I will try to keep this updated throughout my recovery process.  Check the labels for "compartment syndrome" and "fasciotomy" and hopefully (this summer!) under "run"! 

Two!

Just finished my first two mile run since March! 

I changed my form a bit by leaning forward. It felt awkward, but I only had minimal back discomfort. 

I remembered my high school track coaches telling me I ran with my back arched- almost like I was leaning backwards. There are pictures floating around somewhere that prove my form was off.  

Making this little correction helped reach my seemingly illusive goal of running two miles without stopping.  

My next short term goals: run 3 times/week, run 3 2 mile runs without pain over the course of a week, run a 5k!!!  

Long term goals: run 6 miles, complete a 10k then a 1/2 marathon. 

I would love to complete the marathon I'm signed up to do in November, but it doesn't look like that is going to happen this year.  

For now, I will be happy with running two (very slow) miles. I am happy, but not content.  I must keep trying to do more. 

On another fitness note, The Best Man and I finally joined a gym.  We have been going at least 3x/week, doing a little cardio, a lot of weights and loads of stretching.  I'm hoping this will help with returning to run. I need to continue to strengthen my hip abductors and stretch my hip flexors and piriformi. 

Run happy! 

Back on track....

I'm on fire this week! I have run 1.5 miles. TWICE!

Okay. So this may sound wimpy, but its the farthest my body has let me run since the marathon in March.

Here's hoping I can run Richmond in the fall! 

(Okay, let's be honest. I will probably have to downgrade to the half. But hey. Its a start!)

The Best Man Turns 30!

We just got back from a fabulous (ly HOT) trip to Vegas!  I had several birthday surprises for The Best Man.

1) Helicopter Tour of The Las Vegas Strip

2) Penn & Teller

3) The Neon Museum Tour

It was pretty much the coolest trip (to Vegas) ever!

Back to running...one half mile at a time

Over the past month I have slowly gotten back into running. One. Slow. Half. Mile. At. A. Time.

It's disheartening to have old people walk briskly past me while I am warming and ask that I move along faster.

However, it does feel good to feel the wind in my hair and the ground moving under my feet. If only for a half mile at a time. It's better than nothing, right?

I have already signed up for the Richmond Marathon in November. This means I need to start training in ONE MONTH.  Yikes.

Hawaii

I am spoiled rotten and am currently in Maui celebrating my 30th birthday. We will be here for a week and have already enjoyed ourselves immensely.

We arrived yesterday morning around 10 am. We went to a farmers market, got my free scoop of Ben & Jerry's ice cream, then went to the local taco shop, Maui Tacos, for a quick bite to eat before hitting the beach.

We tested out the water, enjoyed the view and took a nap before checking into our B&B. We got some great restaurant recommendations and had some poke and blacked mahi mahi for dinner. Then we went to bed early to get our beauty sleep before seeing sunrise at Haleakala this morning.

We listened to the guide books to go to a look out before the summit and were tickled to have the whole place to ourselves.

It was magical.

We then had a delicious breakfast the The Kula Lodge. We stuffed ourselves silly before heading to some farms: a lavender farm and a goat farm. More on that later.

More pictures and video to come. Stay tuned!