Sunday, February 20, 2011

Setbacks and steps forward

It's been awhile since I posted anything, and I apologize for not keeping folks updated.  It's been a crazy, scary month and I wanted to have something positive to share in this space.  To say the last 5 months has been a roller coaster ride is a major understatement.  It's like saying there are a few Geico commercials these days.  Apologies to Mr. Buffett...I do enjoy the commercials, but I'm getting tired of them as much as I'm getting tired of being injured.  There is good news to share nonetheless...

As many of you know, I started riding the bike over the holidays and even did some elliptical work in January.  I gave up the crutches for a couple weeks and progressed to the point of walking unassisted (but with a limp).  I was psyched with my progress, but my Doc du jour (#4) insisted that we needed to remove the screw in my knee to put some load on the fracture site and promote good healing.  As an engineer, the logic made total sense to me, and I was assigned a surgery date of January 25.  Charlotte and I drove to NYC for the 5 minute operation.   I elected to remain conscious for the whole thing.  My anesthesiologist was a female marathon runner, so I did my best sales pitch on her to run the Traprock 50K (while she pumped a nice pain killing cocktail in my body) as the screw was extracted.  What can I say?  Traprock or bust!  The operation was a success, and I hobbled out of the hospital under my own power and drove home thinking all was good with the world.  Charlotte and I chatted away and discussed plans for the future.

When I arrived at home, I knew something was wrong when I got out of the car.  The pain had increased to the point that I could hardly walk.  It felt like the worst Charlie horse you could imagine.  By that evening, I was ready for painkillers, so Goat and I made a run to CVS for some hard stuff.  By the next morning, I could barely touch my foot to the ground without screaming.  It was ugly.  Furthermore, I could see that my foot seemed twisted counterclockwise.   "Is it me or is it really?", I kept wondering.  I could hardly walk with the cane after 2 days, so switched back to crutches.  My knee felt hyperextended and the pain was incredible.  I contacted the Doc and he told me to come back for an X-ray on Monday.  The x-ray showed that the gap had closed and that I lost approx. 5 mm in length due to the compression.  The doc insisted that my legs were equal length now as he believe it was set in an extended position originally (hence the gap).  He also said the rotation was fine.  In fact, the surgery did exactly what he wanted.  The gap was closed and we had good bone to bone contact which would promote good healing.  I drove home as confused as ever.  The pain over the next 2 weeks was incredible and the mental distress of having lost nearly 1/4" in leg length was even worse.  I went back to Doctor #3 for his assessment.  He indicated that I did have a leg length discrepancy with some rotation, but he could not make a firm recommendation until we knew the exact nature of the situation.  He recommended a catscan to assess the length and rotation.  After consulting a radiologist friend about the radiation exposure, I decided to go for the catscan and get some data.  The results indicated 3-3.5mm leg length discrepancy (about 1/8") and 7 degrees rotation.  I consulted Doctors 3,4 and now #5 and they all agreed the situation did not warrant any additional surgery.  I was within 1 sigma variation of perfect alignment which meant I would be fine for an average person.  For the question of whether I could ever run 100 miles again...I was on my own.  OK, I thought, I can live with it if I can live pain free and without a limp...I can be an average guy.  Just stop the pain!

I don't like the leg length discrepancy.  1/8" does not sound like a lot, but it feels like a lot to me.  It is said that most people cannot detect a 1/8" difference and podiatrists typically do not shim for that level of discrepancy.  My concern is whether I bottomed out at 1/8" or if it kept moving.  At this point, I think it has found it's happy home, and is healing rapidly.  The awkwardness and imbalance are improving each day.  I'm sure it will be fine in the long run (no pun intended), but it's hard to come to grips with it right now.  I can spin on a dime with my right leg, and I don't care for it.  The good news is that the 7 degrees seems to be less of an issue each day, and the pain level is steadily improving.  I've managed to start walking without the cane the past couple of days, but I still have a limp.  I believe the limp is do to the muscle imbalance because I seem to be walking without a limp when I use the cane.   Since the Docs don't want me doing PT until the callus can be confirmed via x-ray, I have adopted a few exercises to strengthen my balance in an effort to lose the limp.

I've ridden the stationary bike 3 times in the past week.  The first time was extremely painful and somewhat discouraging.  The second attempt was much better, and today I cranked for 35 minutes at a pace of approx. 18 mph.  I think I may go again tomorrow night to do a little more work.  The balance and limp seem to be getting better, and I think I'm almost back to where I was 1 month ago before the screw was removed.

The mental battle over whether removing the screw was a good decision was a tough one, but I've come to terms with it.  If I can escape this event with only a 1/8" leg length difference, I consider myself a very lucky man.  I fell 100 feet and lived to tell about it.  The director at the YMCA reminded me of it today.  Over the past weeks and months, many of you have reminded me how lucky I was to be alive with only a broken femur.  Unfortunately, the pain level (mentally and physically) over the past 5 months has been so great at times that it was hard for me to appreciate my good fortunes.  It's hard to understand, but it's hard to cope when people need to do most of your domestic chores for you, when your friends are out running without you, and you just sit around playing mental games all day.

Over the past month, I have had an ongoing negotiation with God.  I asked for the pain to go away and to just let me walk normally without a limp.  I asked for the ability to hike without pain and sit at a desk without having to shift every 10 minutes.  I was so distraught that I did not ask to run again.  It was something that I was willing to sacrifice in the negotiation.  Just let me live a normal life and I will be OK.

Of course, as each day improves, the terms of the negotiation change.  As the pain level improves and the walking gets better, I start to think forward to the next steps.  I believe I will run again, but not sure how often or how far.  Will there be pain?  Will it be temporary?  Will I need a shim in my shoe?  Will I be able to run that marathon with my granddaughter in 20 years (she turns 2 tomorrow :-). Will I ever run another ultra?  Is it too much to even think about running another 100 miler?

I guess all of these questions will be answered in due time.  I am learning to practice patience and take each day as it comes.  I told my boss that my goal was to walk without a limp by April 1.  It's funny... I had planned to run another 100 miler this year, and now my goal is to walk without a limp.

Things are looking good though, so perhaps the April 1 date will move up by a few weeks.  I'd love to be able to walk the Traprock 50K course.  If I can start PT before April, I may even be able to run by June.  Wouldn't that be something?

I need to be patient though.  Right now, I'm happy to be able to walk to the mailbox, carry my laundry up the stairs, and do my own grocery shopping.  These are all things that I appreciate so much more now.

I gave my big screen TV to my Dad last night.  I had my cable TV service disconnected a couple months ago, and haven't really missed it.  I mentioned it to my Dad and offered him the TV on Christmas day.  His eyes lit up, and I knew there was no turning back at that point.  I know he will enjoy it in a big way which will give me more satisfaction than watching it could ever provide me.  My Mom always said, "Your health is your wealth".  Never worry about money as long as you have your health because you can always earn more money if you are healthy.  She is a wise woman.  I'm working on the health part now, and hope to be back in the black (in terms of health) before too long.

It would make a great story...running another 100 miler.  It's something to dream about...but for now the focus is on walking.

Looking forward to the first steps along the way.



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