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.

Cincinnati Flying Pig 3 Way Challenge Race Recap: Sunday's 1/2 marathon

 

 After Saturday's races, I basically chilled out, iced,wore compression socks, and even tried an Epsom salt bath to help recover my legs.  There was also generous helpings of Advil.  My ankle felt pretty decent considering.  I thought I'd feel way worse. 

Before the race!

Running the Flying Pig on Sunday makes for a pretty early morning.  The race starts at 6:30 but to get there with time to spare meant a 3:30 wake up for me, and a pick up of my running partner by 4:30.  Bagel and coffee in the car for me. 

Fast forward to the race. 

My race plan was to finish.  I was going to run 5 mins/walk 1 min.  I decided to run the first mile or so without walk breaks since it was so packed with people.  I didn't want to be THAT runner that stops in front of others.  I made it to the first bridge which probably wasn't even a mile, my legs were tired.  Uh oh.  This was going to be a long race!  So, I took my walk break- that was so hard to walk with everyone running by me!!!! I'm so NOT used to doing races that way.  Anyways, for the first 5 miles my legs were feeling tired and sluggish and I used my walk breaks because I needed them.  I took my energy gels every 30 mins- thank goodness I had enough left over from my last 26.2. 
By mile 6, I was not feeling tired anymore and my ankle was feeling fine.  I just kept slugging through the miles, 5 minutes at a time.  I have to say it helped thinking I only have to run for 5 minutes then I get a break.  Also, since I was just trying to finish- I never looked at my Garmin. I

Yep, nothing like a race photo while you're walking!

was going on my interval timer on my iPhone.  At mile 6-7 I spent my time looking out for some friends from high school who was going to be cheering on a certain corner.  I found them! That gave me a boost to climb the hill. 

The rest  of the race was a blur.  I was so focused on putting one foot in front of the other and only for 5 minutes at  time.  Plus I had to remember e-gels for energy since I remember bonking at the Air Force marathon. 
Mile 11 is all down hill and I got a text from my running partner that she had finished.  I didn't look at my phone since it was strapped to my arm but who else would text me at that time of day? I knew she must of finished and here I was at mile 11 still.  Grrr. :-)  I was feeling pretty good though.
 At mile 12, I looked at my overall time finally and it was 1:54- hmmm, I'm 1.1 miles from the finish and I know I can run 8 min miles and I feel pretty good- hell- I'm going for it!   I like, at all.    Plus, I felt good after. 

finished in 2:04.  I'll take it.  That is only 13 mins slower that my normal time for a half and I didn't really train,
Ankle:  Sore, but not as swollen as I expected- I wore my heavy duty compression socks in the race and generally, ice and Advil and I was good.  My PTs were impressed when I came in on Mon with my ankle looking "normal". 

Can you tell where my walk breaks are in my timing chart?  Plus, love the elevation of the Pig- not for wimps!

 After I met up with my running partner and we found the 3 way challenge table to pick up my extra swag for finishing all the races. 

Front, nice Asics tech long sleeve shirt

Back

All the shirts for the races, 5k &10k are a nice soft cotton, 13.1 tech shirt

Cincinnati Flying Pig 3 Way Challenge Race Recap: Saturday's races

I had decided to run the 3 way back in October and always had planned on running the 10k as best as I could and then do the 5k with the family.  So that's what I did.

My training had been spotty considering I was/still am coming back from my ankle injury which is BTW is taking way longer than expected.

Week 1 and 2 look good, then injury, then you can see my mileage per week is pathetic considering I was going to be doing 9.3 on Saturday and 13.1 on Sunday

Anyways, I knew I could run 6 miles since I had been spinning as well so I knew my cardio would be there but I wasn't sure how I would do with back to back races then a half the next day.

10k Race

The 10k race would be the only race that I knew I could really try at considering it was a distance I could do and no one would be running it with me...so I decided to put on my music and just do what I could.
I felt pretty good during the whole thing, except mile 4-5 which was against the wind.  I like the 10k because there aren't a ton of people like the half and the 5k.  The "hills" are really the bridges with the exception of one and it's not bad.  My ankle felt decent- just would hurt a bit on the hills.  Finished in 51:31 and got 12th in my AG! WOOT! 

I had about an 1.5 hrs to warm-down/warm-up hang out with the family before the 5k.  This was going to be Buster's first 5k and my DH's first 5k in a few years.

tree climbing before the 5k while I stretched

 5k

This was going to be about finishing not about time.  Cub and I were going to run together since Buster and dh were a bit slower than us.  The 5k is so big, it was a bit too crazy.  We were dodging people/walkers the entire 3.1 miles.  It was fun though to go slow and talk Cub through it.  We walked only once which isn't bad at all considering Cub just has been training by playing soccer all spring.

Overall, my ankle felt decent- I was worried that it would be really sore after the 10k considering usually after my runs is when it is the sorest.   I think the compression socks help but also mentally just focusing on the races and not worrying about my ankle helped.  

2 races down, 1 big one to go!

Compression and carb loading for the next race!

Cincinnati Flying Pig 3 Way Challenge: Race Recap part 1

Sorry this has taken so long to post.  I've been dealing with the end of the school year stuff and too much soccer for Cub.  I've been busy to say the least. 

History:  I've run the Flying Pig 10k two years ago, 1/2 marathon last year, and this year:  Flying Pig 3 way challenge, which means you run a 10k, then a 5k on Saturday AM then the 1/2 marathon on Sunday AM.  I'd planned since October to do this and was completely bummed when I messed up my ankle in Jan and didn't think I'd run it.    I think it is so cool that you can run this!  Where else can you do that all in a weekend?  

Expo:  This expo is pretty darn extensive.  Packet pick up was pretty straight forward, they had the 3 way and 4 way challenge bibs set apart so no need to get in 3 separate lines.  I still did since I was getting my running partner (I guess I can still call her that) and my kids and dh's bibs for the 5k.

 The Flying Pig Marathon is sponsored by Procter and Gamble which means: tons of free samples!!! woot! woot!  They have a very well organized line that went fast and I now have a nice supply of Olay Regenerist lotion, Secret, Gain, Tampax, and a ton of other stuff which my dh squirreled away before I take a picture of the loot pile.  (We had 4 participant bags so we took handfuls of stuff). 

The normal venders were there and I did score a new sweaty band for my birthday and some blister powder (since I got a hot spot on foot on my last run before the races-I was paranoid). I also bought a new pair of running/athletic sunglasses since I hate squinting while running in the summer.  We checked out I have to say it's nice having your birthday always around the same time as the Pig-I just drag my dh with me to the expo and birthday shop! ;-)

My favorite Flying Pig and all my loot!

2013 Race Shirts

 At the end of the expo center (it took us a good 1.5hrs to get through) we got to the shirts and the premiums for the half/full runners.  This year they gave us a nice soft cooler with the flying pig logo, nice cotton tees for the 5k, 10k and  an Asics tech shirt for the half.  Then they give out these cool posters with the artwork from the shirt. 

I love this expo!  It's totally worth the extra trip down to Cinci! 

PS If you love my t-shirt "I run this body" check out http://www.mile-posts.com/

Tomorrow:  Flying Pig 3 way challenge 5k and 10k race recaps

I'm alive!

I have been super busy with family and work...but I will say this:  I finished the Pig 3 way challenge! Race report in the future.

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. 

Waiting game

Ankle update: 

Nothing like wasting (well- I cleaned a bit) my spring break waiting for insurance to approve my MRI.  It's only taken 2 weeks.  Finally get a call at 6:30 on Friday night telling me my doctor ordered a CT scan not an MRI (which is what Monday's call was about - who knew a CAT scan and a CT were the same thing?)  

My Dr had thrown out both types of scans in our conversation- but I thought we decided on MRI (better for soft tissue) over a CT (better for bones).  Anyways, at this point and much googling, I'm sure the CT will probably be better for my anterior bony lump anyways.   Now, I have to arrange a time to call the imagining center with Anthem to arrange it- which will have to be after work hours since I can't take calls (like normal people) or use my cell phone (like normal people) at work.  So maybe I'll get this done by May. 

Running update:  

Ran on Thursday- still feeling it on Saturday.  Grrrrr.  Although, I did managed to knock out a 26:34 5k.  8:33 pace.  Feeling good about my cardio and music selection!  I just wish I wasn't feeling it after so much- it felt fine while I ran.  This raw hamburger tender feeling in the joint is not fun.   BTW 12 weeks and counting since this ankle stuff started.  Depressing.

Spinning miles this week:  70 miles and 4 classes, talked about getting certified to teaching spinning with someone at the Rec, might be worth it at this point.  Although, I'm afraid, I won't get a hard workout in then since I'll actually have to talk instead of focusing on breathing.   But, considering how slow this recovery is going, might as well!  Or get a road bike.

Some funny pics for "Waiting" on Pinterest.

March update: 13 13.1s in 2013 challenge

Wow!  I'm so impressed by how much you guys have run!!!!  Seriously though, I'm super jealous that you guys are doing this and I'm still dealing with this ankle.  I guess I biked 88 miles last week- if that counts for anything! :-)

Here is what I have from you guys so far.  Please email me/dailymile message me/leave a comment and I'll add any that I haven't seen.  

1.  Renee C. with 7 !   
 2.Aneta Z with 6!
3.  Tammie W. with 3
3.  Bill with 3 (2=26.2) plus one last month- total of 4 
3. Mitzi with 3 (I know you've run more- update me!)
3. Yolanda with 3 (same thing- update me!)
4. Shona W with 2 (update?)
5. Carrie R.  aka my running partner- nothing yet, right?

Please let me know if I forgot anyone!  Feel free to join as well!  
 

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.