Air Force Recap aka I did it!

Can you say busy?  PT x3 week, 2 boys x2 soccer games a week, attempting to spin1-2x week, work x5, oh, and we found a house we want to get...so add in realtor, etc = blog failing to get updated.

So I'll give you my update in picture format.

"Run as tolerated"

Shout out to my running partner who got 2nd in her age group!

I have to explain, the dips are my walk breaks which get farther apart as I go!

No pain after!Shocking, I know, for me too! I was expecting some at least.

 So, after 2 PT sessions this week, they've let me go! I'm going to be taking it easy since my IT bands are tight this week, but hoping that the foam roller will help out.  So from ankle surgery to half marathon 12 weeks and 1 day. 

Now....for that Flying Pig Marathon in May...

Cleared to exercise (kind of)

I guess I might as well get one post in before the craziness of back to school/soccer season starts and my blog posts suffer more than they already are.

Ankle, ankle and more ankle stuff.  I swear my life revolves around it. 

I looked WAY cooler with one foot on the ground and the other pushing this forward.

• Dr said 2-3 more weeks with the boot (I'm writing this at the end of week 2) but I'll tell you I am hurting tonight after just being at work and walking around for about 5 hrs. The last week, I'm supposed to be working towards transitioning into shoes, but honestly, I don't see it.  I'm going from be a couch potato recovery mood for 6 weeks to standing on my feet for 7 plus hours, without a boot?!  I'm going to baby this ankle for at least a week more. 
  
  
   
• Dr said I could start to exercise on the elliptical (hell NO!) and I could start spinning again.(hell YES)  Yay!  Of course, when I hear "Go" I really went for it.  It happens that they are offering spinning classes multiple times a day this week.  Yep, "overdoing it", 5 classes in 3 days.  It felt great to be back but I'm feeling it a bit too.  My ankle didn't hurt while doing it but it was swollen and tender later.  

• I started PT this week.  Sadly, it was like a homecoming of sorts since I have been going there all spring.  My one PT said I should get a personalized parking spot since I'm there so much.  I shouldn't be surprised that I can't do much, but sometimes I really am.  Today, I had to put my foot on this sliding board and just push it forward and backward.  Holy cow, that hurt like crazy.  Pushing my foot back was insanely hard and did I mention it hurt?

• On top of my celebrating my return of sorts to exercising, my FAVORITE brand for workout shirts is having a SALE which they never have.   YMX Yellowman  has the most amazing shirts.  Normally the tees run about $70 but they are on sale for $30.  I have 2 already and have worn them at least once a week for the last year. They wash up amazing, they have fabulous designs and the maxcool fabric feels like silk yet wicking!  I just bought 2 more and a tank.  I can't wait to see what is up next since they are only doing a few items for 3 days then its on to something else for $30.  Here's my review from last year.  YMX shirt review

Obligatory Ankle Scar photos

This is about 4.5 weeks post op

What an "mini open partial excision" scar looks like. Not as mini as I'd hoped. That's about 1.5".

tiny ankle arthroscopy scar

Random recovery thoughts

Recovery?
I'm not even sure I should write anything, I've been so boring.  Recovery has been going well.  I've been a very good patient.  I'm doing my lovely at home PT exercises: pointing toes, seated heel lifts (still make my calf shake), writing the ABC's with my foot, pushing in and out on a pillow, seated calf stretches and spreading my toes.  Fun times.  All are pretty easy with the exception of the calf raises (shaking leg) and the complete lack of being able to spread my toes.

Why can't I do this?

The toe thing kind of bothers me.  I can completely focus on it and nothing.  I wonder if it's nerve damage? I don't have any pain or numbness associated with it at all, and I can curl my toes just not spread them- so what ever muscle/tendon that does that, isn't happy.  Does it matter if I can't spread my toes?   My foot doesn't appear to be swollen except to me, I can notice the subtle differences. I'm hoping that the DR will explain that to me tomorrow.

I'm hoping to be done with the boot, since this weekend I haven't been the good patient and I've been walking around without the boot at home.  I wanted to test out the ankle, and it feels weak and stiff, but not painful.  Then when I shower, standing on it for 20 mins it hurts a bit.  The few times we've gone out for errands, I can do about 2 hours in the boot before it hurts enough for me to call it quits.  What does that mean? I guess I'll let my Dr. make that call.

Exercise?

Yep, my exercise buddies on the recumbent.

I started last week going to the Rec for a weights class which is pretty good. I'm sore the next day but not crippling sore like TRX.
Also, I'm riding the recumbent bike for an hour.  That sucks. Not going to lie.
1st- I hate sitting in the angle that seat is at, it hurts my butt and unlike a spin bike, you can't get out of the saddle to get relief.
2nd-Old people like the recumbent, and unfortunately some of them have the old person smell, which makes me gag.  I've only had to leave the bike once and do something else and wait for them to be done.  Good thing, is they don't ride the bike for more than 10 mins.  I cringe everytime someone gets on the bike next to the one I'm on.
3rd- It's not spinning, it's hardly a workout to me. But, I do sweat and get my heart rate up, so... I guess it kind of works.

Footwear?
The thing I'm anxious about, other than the toes, is standing on my ankle in 2 weeks when I go back to work.  I'm able to chill out at home right now, go out a bit, but sit when I need to.  I'm not sure I can stand for about 6 hours.  I'm always tired after for the first 2 weeks or so when I'm healthy, but now?  If I have the boot still, my hip will be screaming at me-since the whole lopsidedness is bad (even with shoes about the same height). If I don't have the boot anymore, I have to pick between cute shoes that have no support and swollen feet or practical shoes (i.e. running shoes) which are not dressy at all.  I hate to be so casual the first few weeks back to work.  I've been so casual the last 2 years with all my foot problems and I really miss wearing cute outfits but running shoes and maxi dresses just don't go together nor do the khakis with running shoes look.

Old Runner's Worlds?

While elevating my foot and chilling out, I went through all my old Runner's World magazines.  That was sort of depressing, but at the same time wishful thinking.  I always try to save the workouts that I want to try and/or stretches and exercises that would be helpful to me. I end up tearing them out and then putting them somewhere and forgetting about them.  I took an idea the my DH does for work and I took pictures of all the articles/workouts and created an album on my phone so that I can access the exercises when I'm at the gym.  Brilliant!

Lazy recovery time

Recovery is hard.  I mean, sitting around all day with your foot up, watching the Tour de France, followed by marathon sessions of Mad Men, True Blood (after the children have gone to bed) and Portlandia is really hard.  Actually, I'm so sick of sitting. Couch, arm chair, in bed.  Ugh, Can I just walk already?  I miss getting up and grabbing a cup of coffee, water, etc.

Buster made my whole lunch, cut the apple and everything!

DH, Buster and Cub have all been so helpful.  The boys have made me breakfast almost everyday, and even lunch when DH was mowing the lawn.  I think they've done an amazing job for being 9 and 6. 


It's sad when your big activity for the day is taking a shower.  Although, I did wander out a few times. One trip to Target with the boys.  I have to say I love the scooters.  The boys both wanted a little ride on my lap which worked for about 5 minutes.  I only managed to bang into a few clothing racks (totally embarrassing when you have to go in reverse with the loud "beep, beep").  I think everyone stared at me though, but thank goodness I had that heavy splint on. 

Sleeping with a huge splint on also is extremely annoying.  The first few nights were ok, since I was on pain meds that knocked me out. After a few days though, it was rough.  I don't like sleeping on my

back and I move around a lot at night.  So,  finally managed a way of resting my splint on a pillow so that I could comfortably lay on my side.  Also, getting up in the middle of the night with crutches kind of sucks. 

Ok, so enough with the complaining.  On a positive note, pain has been minimal.  My incision site on the medial side is the one that hurts but I knew that one was going to be bigger.   I didn't know how much bigger since it was wrapped up for 12 days.

Yesterday, I had my follow up appointment.  Here's what I wanted to hear: "Incision looks great, wear your boot, until you can walk without it. No need for crutches anymore.  Feel free to start PT and go ahead and start spinning.  Run when you are ready." 
Here's what I got:  Incisions look great, wear your boot for 3 weeks, no need to start PT yet since they won't be able to do much for you right now, no spinning unless you want a world of pain, crutches as needed. boo.

He did tell me exactly what they (Dr and Resident?) found.  I had a menscoid legion between my fibula and tibia from a high ankle sprain (assuming that was with the initial avulsion fracture) that wasn't the source of my pain but they took it out anyways, they cleaned up the inflammation in my ankle joint called synovitis, and took off 2 bone spurs that were on my talus and my tibia that would bang into each other (otherwise known as kissing spurs) when I flexed my ankle.
 

All the inflammation was from the spurs not arthritis like he thought.  My cartilage looked great, no lesions.  I'm extremely happy about that since I never believed I had arthritis. I had the symptoms, yes, but I couldn't wrap my head around having it.  I probably would still be in denial even if he told me I had it.  

So, finally got the splint off.  I have a tiny little incision on the lateral ankle side and a bigger than expected incision on the medial side-about 2 inches.  Leg hair shorter than expected (thank God!), and I could actually flex my ankle a little bit (enough that Dr was impressed I do that much after splint).

last of the Oompa Loompa Skin plus some lovely stitches

Pampered ankle with steri-strips and nail polish!

So I get to use my boot again, the ankle is in a different angle now so I'm feeling the incision area more, crutches still.  I can at least put my foot down with minimal pressure on it but it's a start.

Ankle Surgery Decision

Back in April I had my MRI and discussion with my Dr about my ankle pain.  You can read about that here. I managed to do my big races at the Flying Pig in the beginning of May with not much pain.  Granted, compression socks and Advil were a pivotal role in my success. My PTs were very surprised that I was able to finish all three races and were expecting a mess when I came in on the Monday after.  My ankle was sore and crunchy but I could walk w/o pain. 

My newest PT, I'll call her Michelle, who comes from a sports clinic, gave me the talk.  "You need to stop running for 2 weeks and completely rest it.  It's not about running now, it's about running in the future."  Yep.  She's right.  Grrr.  So, I was good.  I rested for long 10 days.  Meanwhile, Michelle looked at my new running shoes that showed up in and deemed them unfit for my foot.  I have always wore a Neutral shoe (Mizuno Wave Riders) but she showed me why I needed to be in a shoe for Supination.  I had 2 weeks to try out another pair of shoes and return the old (new) shoes.  I was getting close to 2 weeks but I hadn't got to run in them yet.  That was part of my reasoning for starting to run again but also, my ankle felt the same even with rest.   If I try to dorsaflex, stretch my calf, lounge, walk up hills, walk down stairs it still hurts.  (Michelle gave me her blessing to go ahead and run again)

Michelle asked me when I was going back to the Dr. for a follow up- I told her I wasn't.  My Dr. told me to come back when the spur was killing me and we could do a "scope" to clean it up and shave off the bone spur.    Michelle looked at me, nodded her head and said "Just do it, it's stopping you from doing what you want."  She explained to me the general recovery for it and said I'd be walking within a day or 2.   Ok, doesn't sound THAT bad.  
 

I'm not a radiologist, but I think that's a spur hanging down from my tibia (left hand side, in the middle of the red triangle)

So, here I am, waiting to have arthroscopic surgery on my ankle spur(s?) next Friday.  My Dr. told me that he might have to open me up a little bit more than just the portals for the arthroscope to get at the spur- just depends when he gets in there.  Recovery would be 5 weeks in the BOOT and nothing about being non-weight bearing so that's good, although I did clarify with the nurse and she told me to bring my crutches and boot to the hospital, so...fingers crossed that will only be for a little bit. 

 I do have my doubts.  I can run with little pain.  BUT, I'm in pain later.  Today, I went for a run and as usual I was hyper-focused on my ankle.  It didn't hurt to bad, just on hills (up and down) and I thought "Why am I having surgery on this? I can function, with some pain, but it's not horrible."  BUT, if I didn't do anything about it, I'd stay in this stupid, frustrating situation.  Run, then pain, repeat. 
I want to compete. I don't want to have to run every other day and only 3 miles. I don't want to be the person who can't run because it hurts her ankle too much.  I refuse to stop.  So, I guess that's it.  I have to get this taken care of.

My PT added some anxiety since she asked me if he was going to be doing a micro fracture on the ankle and asked if Dr brought up OCD (Osteochrondral defect).  He didn't, thank goodness, since Dr. Google brought up some scary stuff.    My real Dr. did not mention this, and when I look at my patient summary for the surgery it mentions "General or localized osteoarthrosis" which means I'm old that I have arthritis. If you google "localized arthritis" it is this OCD stuff. I looked at my MRI and at MRIs online of an OCD of the ankle and I think I'm good- but then again, I'm not a radiologist.  (Although it is fascinating, maybe a second career option...) 

my lovely ankle MRI of my talus

someone else's MRI with OCD in the talus

  Since, if I timed it right, 5 weeks in a boot gets me to Aug 2 (perfect for me-done with it before going back to work mid August), and gives me 6 weeks to train for the Air Force Half which stupidly I signed up for back on Jan 1.  I'm hoping this is an easy recovery. 

Has anyone had arthroscopic surgery on their ankle before?  I'd love read about your experiences.

and the results are in!

4 weeks later and I finally know what is going on in my ankle!  I'll spare you the details of what scheduling was like...but I ended up getting in at 7am.  Good thing I'm an early riser (not by choice- but for work).



So here is what the MRI report says: (my comments in pink)

There is signal abnormality within the distal fibula which is non specific possibly related to bone contusion.  Additional marrow signal alteration is also seen however with the medial malleolus (inside ankle bone) as well as the as the more inferior portions of the talus.  Little if any calcaneal signal alteration noted.  Freaked out about this- but Dr says it's pretty normal and it doesn't match my symptoms- although I'd say I have pain in by medial malleolus when I stretch my calf.  Whether these areas relate to additional areas of contusion etc. is difficult to determine.  There is fluid with the ankle joint.  Soft tissue swelling is noted medially and laterally. Yep.  The anterior talofibular ligament is not well defined on this examination compared to prior study and may have partially torn. That would be the goose egg next to anklebone  Exclusion of injury of deeper fibers of the deltoid ligament is difficult.  Had to google this one- once again that inside medial malleolus pain... hum.  Ligamentous structures about the ankle appear to be maintained.  That's good, since it was my calcaneofibular ligament that detached and must have reattach sans problems.There is some non specific enhancement with the bilateral soft tissues which should be clinically correlated particularly if there are any symptoms referable to an infectious/inflammatory process. WTF?  No soft abscess seen.  So, what is that hard lump in front of my ankle? 

Can you find the superior extensor retinaculum?  That's the lump.

Of course, google was not my friend since the MRI report was vague and I knew my Dr would probably tell me it was nothing...and it kind of was. 

He told me that the signal alteration in my marrow is pretty normal to see in a MRI, swelling, yep, and the lump was a thickening of my extensor retinaculum but my tendon in front was fine.  He did find a bone spur that the MRI report didn't include which seems to be my problem.  It is pretty small but as soon as he put his thumb on it- yikes it hurt.  It's right at the distal (bottom) of my tibia next to the medial malleolus.  He told me that we could try an injection or arthroscopic surgery if it hurt too bad.  I heard surgery and started shaking my head.  He said that if/when it was killing me then we could revisit that option later.  He also mentioned that I have mild arthritis (NO! I'm NOT that OLD!). 

So...all this MRI drama and I have nothing really resolved other than knowing what it is.  I'm cleared to run "as tolerated". (I didn't think I had to ask!) And so I did.  6.2 miles right after and 2.62 later that night for Boston. (I don't think I can express my sadness in the whole Boston Marathon attack- too awful so I'm going to spare you). 

Running buddies, photo by Cub

Cub

Around 2,000 runners running 11 laps at the local track for the victims of the Boston Attack

Obligatory Ankle picture (not too swollen from that angle) 14 weeks post injury

I'm going ahead and running the Flying Pig in 2 little weeks from now.    I can do a 10k and a 5k, so now, will I be able run/walk the half?  I'm going to try.  But one race at a time seems to be the best way of looking at it right now. 

Running update

11 weeks post injury- this is this AM before I've really been on my foot today.

•  Dr appt went well, told Dr my problems that I am still having, he again focused on my now hard lump in front of my ankle.  He thinks I might have an impingement which is why I can't flex my ankle.  I'm supposed to get an MRI...which is another story. 

 

• So Mon is Dr appt, I'm to get a call to schedule MRI, I wait til Thursday after work- still no call, grrr, call the Dr office, get call on Fri, "Oh, Dr never put in the MRI order, but it's in the office notes.  You'll get a call next week".  Yesterday, I get a call "Scheduling you for a CAT scan" "What?!, I'm supposed to get a MRI." "Oh, the note says MRI but the order is for a CAT scan, I'll call you back after confirming with the Dr".  So, here I am, day 2 of my vacation- waiting to get this MRI scheduled.  I don't want to take time off of work for the MRI and the follow-up appt if I can help it.  Seriously, people!  

 

• Ran again this past Saturday since the sun was out and the temps in the balmy 50s.   3.1 miles in 28:40.  Ankle hurt the entire time...grrrrrrr.  BUT I RAN 3.1 without stopping.  Yay for keeping my cardio up with spinning. Ankle was a bit pissed off after, but Hey, f- it. 

 

• Walked/Ran on Easter Sunday, again the beautiful weather drew me out and of course, being curious, my walked started with a small run to test out the ankle, then ended about 1.5 miles later.  Again, ankle not happy with me. Good thing it's cold out this week again- probably won't try anything for a while considering I could hardly spin last night it hurt so bad.  

Add caption

• So that's were I am...I've reached the F it stage.  I am tired of not running.  It's been 11 weeks.  I am happy I still have cardio so I'm not out of breath.  This running once a week is not making me happy.  

Race Recap: Yep you read that right

The last 2 years I've done this 5k  both times I've bettered my old high school 5k PR of 21:50.  Two years ago, it was 21:30 and last year it was 21:13.  I love this race! How can you not when you PR every time?  Maybe because it is always chilly and a ton of people who are fast run it, maybe because it's close enough to home, I don't have to get up so early to get there. 

Whatever it is, this year was no different....except for my stinking ankle.  I PR'd again, this time though, it would be my Personal Record worse run 33:31.  I'm not ashamed of it, it is what it is, and I ran 2/3 of it.  Let me back up to last weekend.

9 wks and swollen again.

My friend had a free entry into the Harrigan's race this year and wanted to know if I could do it.  I've been running (if you can call it that) for the last 3 weeks (just once a week- test out the ankle) and on last Friday I ran 1 mile pain free.  (Just some stiffness).   Anyways, I said sure.  I can always walk it.  Then on Sunday this is what my ankle looked like:---------->

Now, I'm doubtful.  I hadn't even done anything, except chill out at home without the ankle brace.   WTH?  So all week, I wondered if I should just bail or walk the whole thing.  I decided finally after the swelling went down and some good PT sessions to just go for it and walk the first half of the race and run the second part. 

Bernie and I after the race.

Day of the race, meaning yesterday, I meet up with my friends Tracy and Bernie at the start of the race.  Bernie is going to walk it with me.  Yay! I was not looking forward to walk by myself.   So, off we go, walking the first mile, trying to stay out of the runner's way.  Lots of tutu clad walkers/runners, and some random dudes in gigantic mustache costumes in the back.  First mile walked in 15:00 pace, so we start to run.  That was the best idea ever!!!!! We passed people the next 2 miles- helped with the depressing idea that I walked in the first place.  Mile 2 in 9:15.  Ankle felt fine- a bit stiff but no pain.  Mile 3 in 9:05- I felt great.  In fact, I told Bernie that I was going to push it the last .25 of it and sprinted past a ton of people. According to my Garmin I had a 5:40 pace for a little bit of it!

Probably my strongest finish ever!

Was running a good idea?  Yes. Totally worth it for keeping me sane.  I can see there is light at the end of this injury tunnel. 
Did I feel it later?  Yep.  My DH doesn't like the comparison to hamburger with my ankle- but it just felt raw and chewed up inside the joint, and tight and pulling on the outside.  Advil and some ice and I'm feeling a bit better today although it's still tender and I won't be running again (until next weekend-that is). 
Next up...Follow up with the Dr. tomorrow if we're not snowed in.  8-10 inches of snow forecast-ed  for overnight and I have an 8 am appt.  Probably going to have to wait on that one.

So proud of my running partner- 3rd place in the old lady category! JK, Carrie!

Ankle day after 5k- not to bad according to the cat.

baby steps on the sly

Quick post today.  I'm tallying any one whose run 13.1 this month.  The totals from last month are here.  Please let me know via email, comment here or on daily mile how many you've ran this month.  I'm so jealous that you guys are running!  

As for me...I've run now 2x this week- both on the sly.  I'm not supposed to run yet, but

• last Sun. I ran 4 steps- wow.  I know.  

• Then this past Saturday, I ran one lap on our indoor track at the rec. 1/11 mile.  Big strides right?  
• Then tonight, in my grumpiness, I ran 1 mile. (or .9 miles)  I'm going to probably regret that in the morning but for now- yippy!!!!   
• Granted, my running form is a complete mess and I'm opening myself up to other compensation injuries...so I will be careful. Plus, my stride was short and choppy and my achilles is tight and behind my ankle bone hurts/stings a bit- so definitely not ready to RUN for fitness yet. 

Nice glass of Whine

 


Quick post since I can't seem to be anything but negative today.  I was told 6 weeks until I could run- hah!- I wish.  It's been 7 weeks since I messed up my ankle. I still can't stretch my calf with out getting pain in front/back of my ankle.  I still hop down stairs since my ROM is not much.

I'm trying to be a good patient.  I've been icing 5x a day, doing my Theraband ankle exercises and going to PT 3x a week. I have not been good about elevating it as much as I should- so I guess I could improve on that.  It's hard since I'm on my feet at work most of the time, then on the weekend, I feel like a lazy bum sitting with my foot up not working on stuff when my DH is busy around the house.  Not much of a blog post, sorry, but I'm sure you don't need more whine with that cheese. :-)


Cardio this week:  Spinning x2 34 miles- good resistance no pain
Days til my race:  63 days!  Could I walk it? maybe? That would be soooo hard for me to do.  I'm too competitive. 

lovely lump on left ankle

Like the sock lines? 

Best Ice Pack ever- 3 parts water, 1 part rubbing alcohol- nice and slushy

10 mins x 5 times a day! fun times!