Wednesday, February 26, 2014

Doing Too Much

My last post I ended by saying that I need to remember I am still injured, and I still need to take it easy! Have I been living that out this week?! It's not that I am trying to sabotage my progress, it's that my life is busy and there is always so much that I want or need to do. I want to take my kids fun places, and keep up with them in general. I want to keep my house clean, and do a good job with the meals menu and the kids' lunches. I want to enjoy the nice weather. I want to put in our landscaping and plant my vegetable garden!

And while I do not condone doing too much, I have to share a pic of my newly planted vegetable garden. The hard part is done!

Ok, I'm officially nuts. I guess I just figure hey, I feel good, so why can't I do these things? Well I'm lying to myself really. I don't feel good, I feel ok. My foot doesn't like doing all of these busy things. I am out of the boot now, but I put it back on if I know I will be walking a lot. I even wore it once to work in the yard but not since because I got it filthy and it took forever to wash (stupid reason, I know).

So...most of the big jobs we've wanted to accomplish around the house are done. Things have been planted and set in motion. Back to normal.

I am most looking forward to a reset. Our forecast is calling for 4 days of rain (which incidentally is also great for my garden), which means a slower pace. I am not planning anything, and here everything we had planned gets canceled in rain. So I am planning on one objective-rest. I plan on baby-ing my leg through those 4 days and doing the bare minimum. Now here's hoping I can stick to it!!

Friday, February 21, 2014

Physical Therapy Week 3

Thursday was my 3rd visit to physical therapy. I went a bit early and was able to spend 20 minutes on the recumbent bike. Then I met with my therapist and got to work! She spent a good amount of time on my incision because it needs to be massaged regularly. She said that incisions like these have a tendency to adhere to underlying tissues: tendon, bone, muscle. She said mine has some adhesions so it needs to be massaged regularly. Then she tried manipulating my lower leg in a few ways to feel the muscles and tendons out.
Here is my leg after having the cast off...and here is my leg last night to compare! It is good to see some progress (and no I am not quite that tan, it was the lighting).

All in all the session was the same. She evaluates some of my exercises to see if I am making progress then shows me new moves she wants me to do in order to strengthen other muscles. This week I get to do special lunges and a move she calls the "Woody Woodpecker" where you stand straight and then lean toward the wall in front of you without bending your legs. It's tough!

By the end of our session I'm usually feeling pretty sore, but it is a good kind of sore. Today I was sore sooner than usual after being on my feet for a while. I am still diligently walking our dog every day, sometimes twice a day, doing stretches and balance/proprioceptive moves along the way.

This afternoon after picking the kids up from school I was so relieved it is Friday. No homework, no place to go.  I was so wiped when we got home that I did something I never do- I turned on a 3 in the afternoon! While I was watching I was icing and by the time the movie was over my leg felt better. It was just so sore and I was so tired. I have been more tired that I'd like lately and I couldn't really pinpoint why until today. I think even though I am progressing, I need to remember that my injury still exists. My achilles is not better yet, and certainly not pulling it's own weight. So it's tiring getting around and doing normal things. Driving and going to the grocery store for example. By the afternoon it is like I have been dragging a club foot around. And it's not that I am dragging my foot, it is just that the deficit is there, so it gets exhausting after a couple hours of walking on it.I have to remember that I have only been out of my walking boot for a week!

But...on to a new day! And keep moving forward (Walt Disney).

Tuesday, February 18, 2014

Therapy Week Two and Ciao! to My Walking Boot!

Last Thursday was Therapy Sesh 2. (It's nearly Wednesday so I'm having trouble keeping up! Life has been keeping me busy.)

We started the session with something kind of exciting. I got to sit on the recumbent bike and discovered I can pedal! If only I had one of those babies at home, I would have a go-to faster-paced workout! It did feel good to be able to do something cardio.

After that warm-up, we worked on some new moves. In addition to the stretches, the therapist added some butt and thigh muscle work. Early in the session I explained that certain calf stretches hurt the medial side of my knee...with a sort of pulling pain. She is suspicious that the lack of regular movement has probably atrophied those muscles and caused some shifting. So they are a new target. And guess what? I can do squats!

She also added some proprioceptive moves. I stand with my legs together, and simply try to stand without swaying. Then I place my arms in different positions. Then I stand on a pillow doing the same thing. Then, off the pillow, I do the moves with my eyes closed. Then likewise, I stand on the pillow, eyes closed. It is all a progressive challenge for those intricate muscles surrounding my ankles.

I also have some heel raises which are not my favorite. I do sets of ten, both legs at the same time. It doesn't feel like my left calf is contracting much yet, but when I watch in the mirror, it is actually doing quite a bit. I just can't feel it much yet, I still have a weird sort of numbness in areas of my calf/achilles.

New Homework!
Lastly, she had me stand on this disc thing and move forward and to the sides and back, just using my lower legs. It started to hurt a little bit, but this was at the end of the session too.

I am feeling more upbeat this week. I came out feeling better than the week before. My walking is getting better so that alone is encouraging.

And the walking boot-oh yeah! Valentine's Day I was officially done with the everyday need of the walking boot. I still put it on if I have to walk a lot or if my leg is feeling overworked, sore or tired.  But it was cool to reach that milestone where I no longer am married to the boot!

Updated incision photo:

39 days post-op!!

Tuesday, February 11, 2014

Therapy, Therapy, Therapy!

I thought I would post a bit of an update on my physical therapy progress. Well so far I have only seen the therapist that initial visit. My second visit is tomorrow and all week I have been doing the stretches and exercises she assigned to me. It is tough! My calf muscle hurts more often, that's for sure. However when I come to think of it, my heel hurts less.

I have to do 4 different stretches, a calf-flexing exercise and I am retraining my foot to walk properly. At first it was really hard. I do 400m stretches with my little dog, going slowly and methodically. It hurt at first and I didn't go the full 400m. But by this morning the first half of it actually felt good and I think after tomorrow's therapy visit, I will add a little bit of distance (extra 200m or so).

The good thing is that it hasn't been hard to find the time to complete the exercises, some several times a day. I am at home during the day so I can easily take a "therapy break" and give myself 15 minutes to do some exercises.

On a separate note, I have also been taking time to do other strength exercises-my usual routine: push-ups, tricep dips, dancer's leg exercises, abs, etc. I think wrapping my head around a physical therapy routine has made it easy to make myself stop and do other exercises too!

Wednesday, February 5, 2014

Post-Op Day 26: Physical Therapy Evaluation!

I have been anticipating this day with much positive energy, I must say! I was really looking forward to understanding the journey ahead of me, and learning active ways I can help further my rehabilitation.

But I have to say...I didn't take it as well as I had hoped!

The physical therapist started by taking measurements and having me do different push-pull exercises to assess my range of motion and strength. Then she showed me stretches she would like me to get started with. I was also surprised to learn that I need to massage my incision site-I had never heard of that for some reason! The logic behind this is that an incision like this one will continue to grow deep into the greater tisses underneath such as bones, muscles and tendons. It can sometimes fuse to them so it is important to massage the incision to break up the growth beneath the skin. It also promotes blood flow and nerve function at the site (which I will admit is a weird-sort of numb at this point).

Lastly she evaluated my walking and showed me how to purposefully regain normal stepping motion. Next week I will hop on the stationary bike and do some more work!

So why was I discouraged when I left? Maybe it was more frustration with my own expectations being unmet. Or maybe it was one of those moments where I allowed myself to realize just how frustrated and heartbroken losing my ability to walk/run/hike/bike has been. Maybe it was a little bit of both. I really miss running (and exercise in general!), and I feel like there is a whole part of myself I have lost. My incision is really long and I am honestly bummed about it. I cried on the way home.

My left (injured) calf is 3" smaller in diameter than my right. That really hit me hard. I expected some change, but to me that feels very significant (and in so little time-2 1/2 months?!?). I know my left is not working at all, and my right is compensating, so there will be an imbalance. But there was something crippling about learning that reality. It will get better when I am healthy again, but how much change will occur as I am still in the boot? There is an exercise I will start working on for that.

Secondly, each exercise was so hard. I could not do them-at least not well in any manner which was very frustrating. I guess I was hoping that I would come to therapy and receive good news. "Oh you are doing SO GOOD already!" or "Oh yes, you will be there in no time!" I didn't get any of those statements. Therapy is hard-really hard. It is pushing past tension (and some pain) in order to bring back function. It is necessary if I want to regain ability so I'm going to do my best!

Here is my "stay positive" picture.

Saturday, February 1, 2014

3 Weeks Post-Op!

I can hardly believe it has already been 3 weeks since I went under the knife. I stop and do the math every time just to make sure because it always seems that there is no way it has already been that long! But sure enough, it has!

It's funny how life goes on, even if you have had surgery. Kids still need to go to school, dinner still needs to be made, bills still need to be paid. But I am thankful for all of that because I have a million reasons to stay busy. I'm on my feet virtually all day, and I am finally feeling very close to normal. I am used to the boot, and I don't even notice it much (unless some stranger points to it and asks me what happened. It seems to happen more than I would like and can be a little awkward...kind of like the stranger touching your pregnant belly...) Often I wear the boot most of the day then just as it is time to make dinner I take it off and it stays off the rest of the night. The days that end with a sore left heel are becoming more even with the days I end without a sore heae.

Yesterday I was wearing flip-flops, no boot, and I noticed that The normal dynamics of walking are slowly returning to my left side. My forefoot was actually a small amount active in the action of walking-yay! How did I notice? Well you know how your flip-flops make the "flip-flop" sound? Well that is usually one sided for me as one side "flip-flops" and the other side does not. Yesterday they were both flip-flopping :)

This is me in my flip-flops, hanging around the house. I can get around ok like this, and I love wearing a wrap. It just feels comfortable to have it all securely wrapped.

Here is my incision now, after unwrapping it for the day. I'm very pleased with how it is healing. The swelling has gone way down and the incision is very healthy! There are still stitches staying strong in there, and I am actually curious as to when they are supposed to dissolve.
On an encouraging note, my physical therapy referrals came in and I have my evaluation appointment next week then sessions each week for the next 8 weeks! I am excited to get this part going. I have been so nervous to try anything that might re-injure my Achilles but I am more than ready to start doing some proactive things to get my strength and motion back.

About two more weeks in the boot!

And yes, in the back of my mind (or maybe more toward the front I will admit), I have been a little concerned with staying in shape, or not falling out of shape! While my legs are still doing ok in shorts (I give some credit to my regular California tan), it is my uppermost thighs, into my rear end that are missing it most. I am grateful that I will have a couple of months to get back into a program before I have to "debut" in a swimsuit this season.

You know though, all in all I am feeling satisfied with myself in spite of these challenges. I have felt a lot of pressure to do whatever I can-strength moves, swimming, whatever, in order to burn calories and work my muscles. Pressure to push forward and find exercise at all costs, despite my injury. That is great, and I am sure some women can or will do all of that. But I think what most won't understand unless they have undergone surgery like this is that recovery itself is exhausting and takes a lot of energy. Getting around with an injured limb is hard and takes a lot of extra effort. Some days I would have to take a break and lay down around mid-day just to get my strength and nerve back in order to keep up with my family. I have been doing some exercises throughout the day; quick push-ups, leg lifts or tricep dips but I have not been pressuring myself to do so. I have been doing it because it feels good. My body is going through other stuff right now. It's like with pregnancy. Staying in shape is great, but overall what is most important is the health of your baby. So maybe you can't run a marathon while pregnant like some crazies can, but you can get out and walk with a friend and do some yoga. My point is, you do what you can. Past that you can't feel guilty! Life continues, even when you are injured and you have to prioritize. It's not the end of the world if, for a season, exercise is not the top of your priority list.

I think what I am most looking forward to is that once I am rehabilitated, I will run again, but this time having overcome something pretty huge...not just the surgery itself but a close-call where I wondered if I would ever run again. Running will never be the same.