Saturday, May 26, 2012

This way to accessible adventures

Membership has its privileged.
Week 5. When the going gets tough the debilitated bug out to California. Over the last week, my careening gate improved enough to surpass the fine tuned surefooted balance of a baby giraffe. We applied the standard COPS field sobriety test to scientifically evaluate my abilities and my wife affirmed my travel visa for a road trip. We had purchased non-refundable airline tickets some months ago. I remain convinced that travel insurance is a government/big business/Freemasonry conspiracy. Or could be I am very slightly economical cheapish. Travel insurance will run you the same price as a new pair of Newton's Gravity series kicks. I prefer to cover the risks myself and buy the shoes. It would have been a travesty to exchange the pre-paid trip for a week's worth of Judge Judy and Jerry Springer episodes. I had to break out of my cell house. So, I pitched the adventure as the proof I needed to convince the doctors to sign my work release papers. They cleared me for any movement in the boot to pain tolerance. I posited if my brevis could drive 5 hours a day and waddle through tourist traps and picturesque trails, my tendon was ready to carry me back to work. With the mobile boot replacing the cast, I wanted to test the mobile part. And true dat homes, my west coast hip hop skills were in decline. Some true chillin in Compton (or safer and more handicap accessible areas nearby)was just what I needed. 

My most ill advised adventure of the trip. Water runs uphill? Magnetism is reversed? Laws of Gravity are suspended?
Morons with bad ankles lose their mind?

Guess which one my boot resembles?
Hint: Its very itchy, smells funny,
 and is NOT attractive. It may have given
me a rash.
In the week following the cast removal and preceding our flight, I increased my long walk limp up to 2.5 miles at a blistering 2.1 mph pace. The boot really improved my mobility and started to engage some of the lower leg muscles, but kept the ankle securely locked into a stationary position. I was directed to sleep in the 9 lb aggravation until my next appointment. The velcro neoprene monstrosity is as large as a small person and made my bed look like a Fleetwood Mac Rolling Stone cover. And its probably just as sanitary. My right leg was bulking up from all of the one leg hopping bathroom drills. But the wonderful perks! I was issued a temporary passport to the glamorous and privileged lifestyle of those requiring additional time to board. With a boot, small limp, and a brave face I copied from Tiny Tim in A Christmas Carol Delta twice waived their $40 seat change fees, moving us up to the bulkhead seats. California Vehicle Code Section 22511.5(b)allows out-of-state handicap placards to be used for parking and the state parks had more reserved parking then my Orthopedic's office. And to top it off, every third person we passed on every trail we attempted let me know I was "awesome bro."

Number 1 cause of injury in a Redwood forest, slipping on a banana slug. Watch your footing.

 RICE (Redwoods, Inclines, Climbing, Elevations)?
We flew into Portland, OR and drove south 1200 miles down 101 and 1 past
Monterey. We hiked Oregon waterfalls, the ancient forests in Humboldt and Redwood state parks, the streets of San Francisco and the coastal beaches near Big Sur. I conquered 2 hotel stationary bikes, an elliptical, and 2 weight rooms. I survived the drunk hillbilly engineered gravity house at confusion hill. By day 3, my ankle doubled in size and developed a slight attitude problem. I fully tested the reclining capabilities of a Nissan Maxima's passenger seat and my foot waved to every commuter from its permanent perch on the dashboard. The medical compression wraps from the doctor's office irritated my skin, so I modeled 4 1/2 pairs of Penny's knee high socks one at a time. Light purple with white stripes were my personal favorite and illicit the most whistles. Hotel ice machines and nightly elevation proved my magic bullet, returning my ankle to near normal by most mornings. Distracted by my surroundings, I engaged the tendon numerous times when I failed to watch my footing. The metal side supports performed their job admiringly, limiting the tendon's rebuke to brief shooting pains and glistening eyes I ingeniously blamed on allergies.

San Francisco: All courteousness suspended when the cable car is full.

Luckily, now able to get my leg wet.
The physical exertions were beyond my abilities, but it felt great pushing the envelope again. The gambit paid off, 2 days after our return and careful resting I was able to talk the surgeon into green lighting my return to work 3 weeks early. We retired the boot and now at 6 weeks I am in a removable air cast. The tendon should be knitted together by now, although very fragile. The white coats insisted on another week for me to get the lower leg muscles out of their state of atrophy. I return May 29. Physical therapy starts in 3 weeks. After I regain the ability to invert the joint, running will finally be on the near horizon. I can elliptical now with just the air cast/brace. It allows full ROM (range of motion) forward and reverse, but refuses inversion. I managed 32 minutes yesterday, but the resulting swelling is impressive. From my research I will be battling inflammation for 2-3 years. Its still too early to reap the rewards. I am very much worse off than before the surgery mobility wise, but I am finally starting to see the hint of the benefits. My challenge will be not overreaching. To distract myself with a goal (and because everyone else is doing it) I am playing with a barefoot return. I have started walking feet naked on the sidewalks too toughen up the skin on my soles. When I finally get to running, its going to be a slow climb back. What better way to adopt a new style that might take some of the force out of my foot strikes and baby my newly constructed limb. Besides I am intrigued by AC reinventing himself with a new running style, envious of BF Josh's speed, and I want to one up Der Scott's running everywhere in bedroom slippers (maybe I will try flip-flops and a bathrobe).

"Stumpy" and the bottom of a Redwood.

65 degree stupidity.
Present status. Scar looks great. Even the tattoo knitted up well. I was secretly hoping for at least a little gore to impress people with. Effort results in some pain the following day (3.5-5 on a 10 scale) and semi-impressive swelling (I think this is slowly improving). ROM is 85% gas pedal motion, 15% side to side. Sleep is 27 times better in the small air cast. Calf size is still very reduced, maybe by 33%. Tib anterior is overtaxed and sore from covering the peroneal's job. A lot of tension built up in the glutes, IT band, and quads on that side. I am going to start rolling again to address these issues, with my increased mobility. Now that I can address blood sugar issues with limited cardio, I can finally begin to reintroduce a higher carbohydrate diet. Blood sugars remain in good control. To date, I am down 5 lbs probably due to the decreased insulin and low carb. My upper body is larger and my core is massively improved as all of my exercise has been free weights or core based. Waist size is down 1.5 inches. My lower body is definitely reduced from the 40 miles per week days. RICE (rest ice compression elevation) approach results are noticeable now. If you have this surgery, week 5-6 looks to be the beginning of the beginning. I am tentatively considering running the Spinx half-marathon with my mom at the end of October if she will wait for me at the finish. The surgeon says its possible if I run it to finish. I would love to Galloway it in. It will be on the best case side of possibilities for me. The 4 hour finish time limit should allow me enough time to moon walk it in if my ankle can't make it. I would love to return this to a running blog. Still hoping for a marathon return to Umstead 2013.
This way to accessible adventures.

Where there's a will there's an accident.

Recovery, finally a light at the end of the tunnel.

Common sense trail.

Safer modes of transportation. But, Sally is not famous for sharing.


Thursday, May 10, 2012

Cast off!

Half  Flowbee half Jaws of Life. It did get warm, but as promised no  blood.
My peroneal brevis repair one month review finds me a bit tired of everything and very aware of the passage of time. In a word, I am a malcontent. The European Journal of Social Psychology suggests it takes an average 66 days to create a habit. Added to more than a months rest before the operation I fear my running addiction is broken by definition. My mood is not helped by my murky understanding of my recovery timeline. Everyone heals differently and the surgeons have radically different approaches to rehabilitation. Can I start to run at 3 months out? 6? 9? Icelandic Hákarl cures for 4-5 months after fermentation. If rotten shark is ready after 120 days, why not my rotten tendon? I have challenged this process at every step, pushing to the edge of my limits. Early out of open splint, early out of cast, early into boot. With this much focused exertion I expect a sub 3:30 marathon. My best efforts, to date, have yielded me a time to my mailbox that I suspect puts me slightly ahead of my Grandmother. Unfortunately, at 83 she is not in my age bracket.

What, me worry?

Butter side up. My cast is past. I wore this  accoutrement for a mere 3 weeks, yet I soon hated it more than Häagen-Dazs hates vegetables. The persecution incited by accumulated skin cells, dried sweat, goat hair, and lost spatula pieces was finally soothed after a terrifying medical encounter performed with what I am sure was a Sawzall. The crazed mechanized saw wielder assured me that the razor sharp, titanium, diamond encrusted alternating blades were perfectly safe. They will apparently cut through fiberglass, sheet metal, and concrete, but remain safe for cheese cloth, wet Klenex, and human skin. The fiberglass shell was sawed off in L shaped cuts and discarded. Then the gauze and filler were scissored away with a straight center cut. Just like that, my desperate skin was reintroduced to fresh air. The nurse did not allow me to bring the steel wool and sandpaper I attempted to smuggle into the cast room. Otherwise, the following scratching was the height of pleasure. 

26.2% less muscle. With the muscle tone of an 11 year old girl, my left leg is no longer able to
attend rated R movies unchaperoned. 

Swelling was within parameters, but apparent. The wound itself looked a bit chunky to me, but its hard to tell what is under the scabbing. It is dry and shows no sign of infection or complication. The steri-strips are to remain on until they fall off. The Franken-boot has been replaced by a Robo-boot that is only to be removed while bathing. It turns out that sleeping with a cement block styled 8 lb rig on your leg is just as comfortable as orthodontia and slightly more convenient than changing your cable company. My calf is no where to be found and combined with the swollen ankle makes my leg look like a stick hangman drawing. The Hermes tattoo looks surprisingly good. Maybe a bit molted. My weight is stable. Lost 3/4 of an inch on the calf. Gained 1/2 in around the ankle measuring just above the malleolus. Blood sugars still controlled with core and upper body work in concert with low carb diet. Just had my physical and posted a 5.3 A1c.

If you peer closely you may be able to see the stink in this picture of a
four week unwashed ankle. Here the  iodine stain is still present
immediately following cast removal.

I am very excited to get back to some kind of cardio that does not involve sit-up, free weights, pull-up circuits. I am cleared for the bike, elliptical, and to a lesser extent hobbling as long as I wear the gear. The boot keeps the ankle anchored and completely immobile. I have already tried a stationary bike, but am experiencing some issues with atrophy (which I will dispatch with shortly) and clanging my size 16 E medical cowboy boot on the frame occasionally. I am still not cleared for work, but am remaining positive about a quick restoration. My next appointment is May 23 where I expect to be placed in a smaller, more mobile brace. I have airline tickets for a previous to surgery planned California road trip that my wife deems too dangerous. I have one week to prove myself not too wobbly. Successful completion of that adventure and rehabbing on the hotel exercise equipment should bolster my case and get my return to work release papers signed by the surgeon. Fingers Xd. I have abandoned all running magazines, blogs, races while condemned to the cast. I hope to catch up as I read through my upcoming bootcersizes. I miss the crazies. I miss all of you wonderful crazies.

4 weeks post surgery. Swelling and degeneration comparison.


Wednesday, May 2, 2012


Violation of post op care. Exhibit A.
Tendon repair + 3 weeks. Pain continues to decrease. At this juncture my range of motion encompasses the full allowance of my rapidly decaying cast. I can now flex up and down about 1.5 inches. My wincibility factor still edges up to 7 whenever my peroneal's have a chance to fire. This usually happens when my balance is challenged and the muscle tightens in futile response. My mobility continues to improve in spite of my fiberglass cage. I have mastered der Scott's no arm crutches technique and am showing great promise as a fledgling hobbler sans crutches. Most mornings, cramps from the surrounding imprisoned muscles issue a rude reveille that last till taps.

Weapons of mass destruction.
The last 7 days widened the cracks in my sanity along with the gap between withered calf and cast. If the itching would take on a human aspect for just a brief moment, I would kick the cojones, tweek the nose, and apply liberal purple nurples with glee. I have renounced Benedryl in favor of more substantial remedies. The post surgical instructions insist that nothing be inserted into the cast. Sage advice that I strictly followed for over 96 hours. As the maddening itch increased, my adherence weakened. After careful rereading, I followed the instruction to the letter. I have never inserted nothing into the wretched boot. I may have inserted a 12 inch screwdriver, electric taped molding, 2 mixing spatulas, a paint stirrer, a belt, and maybe my hand up to the elbow.

New car goat smell.
A mixing spatula will gently massage the skin without ill effect if used delicately and with some reservation. I was very careful with my first exploration. My manic laughter and expletives did not bring the police, but I am sure I woke up more than half of the neighborhood wildlife when I plunged my spatula Excalibur into the heart of my calf's scaly dragon itch. I continued carefully scratching for a brief 2 or 3 hours. When my arm finally tired, I retracted my makeshift sword to discover my weapon significantly reduced. I managed to dig a 2 inch chunk out with the hilt, but found a nickel sized piece remained behind. The cast away piece laughed at my best efforts to dislodge it and hid within the layered mysteries of my cast. I slept and prepared my best excuses for an impromptu doctors visit. When I awoke I felt the wayward rubber embedded onto my heal. Ever seen a cat with tape on it's paws? 

Today's special. Really fresh goat cheese omelet.
Before surrendering to the white coats, my wife and I attempted a home extraction. As temptress and mastermind of the cake batter spatula caper, she was judged responsible. After valiant attempts with a leather belt, a wooden spoon, and telekinesis failed we escalated to the garage. After some close calls and no small amount of carnage we successfully dislodged the menace to the bottom of my foot. A few swift kicks to the kitchen chair and voila; shrapnel expelled, co-pay avoided.

Post-Impressionist. Still has both ears.
To protect the leg, pale the itch and preserve the marriage I accepted my sister's invitation to her relaxing mountain retreat. The 4 hour journey, a trial run to offer 1 proof of function to my doctor and my work's return requirements. I arrived, but barely, the trip proven to be at the outer arc of my limits. Presently I am not allowed to sweat, invert, evert, or get the fiberglass wet. Enter my niece, nephew, chocolate lab, cat, rooster, 3 goats, stairs, gravel drive, no central AC and sudden mountain rain showers, but NO spatulas. I don't know if this was very ambitious or a little stupid, but it turned out to be a great way to distract THE Itchies and blow some of the stink off of my attitude. I narrowly avoided animal pee of several species, goat grazing and the inadvertent crushing of any baby chicks in the living room with Frankenfoot. And had a great time visiting with my family.

In my two and a half day 1 leg odyssey I gorged on the delicious home cooked organic fare that my sister feeds her family. Her emphasis on natural proteins and vegetables nicely complimented my own diabetic diet. A welcome respite from the temptations of my carbohydrate crazed companion at home, as I no longer generate the cardio required to burn pizza, Lucky Charms, and popcorn. An unexplained hypo prevented me from an exciting trip to town for 4 new baby chicks. Need a little more research, but I believe the altitude knocked my insulin needs down by 30%. A 9 mph gator drive, complete with goat escort, left me longing for my trail shoes. There is a Grandfather Mountain Marathon reminiscent road right at the foot of my sisters mountain driveway that runs all the way into the next county. After several shellackings from close family (read vicious  competitors), I knew that Mario Cart practice would henceforth be replacing my daily General Hospital window. As a parting gift my cast was adorned with original works and signed by the artists, my niece and nephew. The most controversial piece, a daring modern take on racism, the environment, wealth distribution, and the waning of religion in a post-global economy by my nephew titled: Alligator in the bathtub. Wish I could get in a bath without a trashcan liner tied around my leg! Thanks for a great visit S. I had a blast.

Alligator in the bathtub. A sharpie sketch on fiberglass.