Soreness

Yesterday I spent a lot of time on my feet. I worked at the NWAC (Northwest Aviator's conference) from 8:30-1, on my feet most of the time, and then at Performance from 1:30-7:30, again, on my feet most of the time. By the time I got on the stationary bike at the end of the day, my foot was feeling pretty sore. But more around the outside of my foot than anywhere else. Wearing a boot that has a perfectly flat sole might have something to do with it.

In the last couple of days I've been puttering about the house barefoot a bit. It doesn't hurt, but I find myself going very slowly for some reason.

One small step for a woman...

... yesterday in physical therapy I walked with crutches, barefoot, across the floor a few times. But I was really using both feet - maybe 70% of my weight was on my feet, the rest on the crutches. It was really exciting. I also did calf raises (with both feet and left foot solo) and squats... both on a machine with very little weight. The calf raise was very difficult for my left foot. We also worked on balance by standing on a foam mat - first with both feet, then alternating feet. I was amazed that I could stand on my left foot all by itself!

While wearing the boot, I pretty much abandoned the crutches today. Walking in the boot is awkward and slow but SO wonderful compared to using crutches. For 2.5 hours this morning I cleaned up the house because I could finally do it - all by myself. I took out the trash and recycling, did laundry (I carried a basketfull of clothes up the stairs). I can even walk up and down stairs putting each foot on a different step - almost as fast as a normal person.

This morning when I woke up something behind my knees (both knees) was sore. I don't know what kind of exercise caused it, but it was pretty exciting to have sore legs - I haven't had that feeling in a long time!!

For now, at least, I'm not taking my newfound freedom for granted. I'm really satisfied and happy and content with my new abilities. Although, knowing myself as well as I do, I doubt that will last for long!

I love my Saturn

I haven't been able to drive my Saturn since I had surgery, 6 weeks ago. But it feels soooo good to be back in it. It's spunky (much more get-up-and-go than the other cars I've been driving), it has my AutoPC (Brent's car doesn't have any music system at all), and it has plenty of room for crutches. Right now it has my bike in the back - we're going to the CompuTrainer place tonight for a workout. I can't wait to give it some TLC (a good wash and vacuum)!

6 weeks post-op Dr.'s visit

First the bad news: the big toe has drifted valgus (outward) by 14 degrees in the last 5 weeks. If it continues to drift, I will probably need another surgery - this time in my big toe. I get the sense that the chances of that aren't too high, so I'm not too concerned. There's nothing I can do about it anyway, right?

The good news is that when the screw comes out in July, it shouldn't be any kind of setback to the healing process. The doc said that I could be up and running the day after surgery.

The other good news is that I can start weight-bearing on my foot now. I won't be boot-free for another 3 weeks or so, but it's still pretty exciting. I can go for a real bike ride (outside) in 3 weeks. Unfortunately, the racing season will be well underway at that point (the first time trial of the season was on Saturday, 3 days ago). Oh, well.

5 weeks and 6 days post-op: A foray into weightbearing

I'm supposed to start weightbearing tomorrow, but I figure starting a day ahead of schedule wouldn't kill me (I figure that 3% early is safe - especially if I am as wolverine-esque as Aaron gives me credit for). I had plenty of opportunity to practice at the bike swap and bike expo that were going on concurrently at Magnuson Park today. I played with the scale in the morning and figured that I felt completely comfortable with 80 pounds of weight on my left foot (still in the boot). So when crutching around in the boot today, I put my left foot on the ground, too, sometimes. When doing that, though, I need to adjust the crutches to be about 1" taller; the boot is so thick that it makes me significantly taller. Walking sans-crutches with the boot will probably be pretty awkward because I won't be able to bend my ankle and because of the difference in elevation of my feet.

A stimulating experience

On Friday I asked PT Shelley Hack if I should be getting electro-stim at the end of our sessions. We had actually tried it on my 2nd visit, but it didn't seem to work. We cranked up the machine to 30, but the little electrode pads kept falling off and even with them on there I never felt anything. So we decided to try again. This time we cranked it up to 50 and I finally felt something (most people use a setting around 15). We're not sure why we had to turn it up so high. I'm guessing it has something to do with the fact that that part of my foot is partly numb from swelling and surgical nerve damage. Of course, if people want to think that I have an unusually high pain threshold, that's fine with me. Like the spinning instructor (Justin Maguire, Pro Club) who kept saying I was "hard core"....

Disappointment

Thursday and Friday I was feeling pretty disappointed in my foot. In a spinning class I tried pushing a bit with my left foot (in the boot still), but it hurt in the IMPJ (inter-metatarsal-phalangeal joint). I guess I was frustrated because I knew I wasn't even pushing that hard. And my 2nd toe seems to be overlapping both my big toe and 3rd toe now... which is worse than it was before surgery. Thinking about that is really depressing, but as long as I avoid thinking about it...

Bendy

Today at PT I bent my big toe without any help. The bruising is almost gone completely, even from my ankle and the bottom of my foot. It's been 36 days (5+ weeks) since surgery.

Shelley continues to be a fun person to work with. I need to do a better job of doing exercises outside of PT, though.

I'm becoming such a regular at the Pro Club that at least one of the guys at the front desk doesn't have to ask for my name any more (Kirk)! I've probably been averaging about 6 times/week these days.

After PT I was on the stationary bike for about 40 minutes. I like the "Hill Plus" program, which is essentially interval training. It's a lot less boring than steady-state work.

The latest dream

Last night I dreamt that I was walking barefoot with both feet at a soccer stadium with astroturf. That was great.

The IMPJ (inter-metatarsal-phalangeal joint) is obviously still swollen, but the ankle is looking better. The color of the foot is often different from the right, depending very much on temperature.

Morning Amnesia

One of my favorite things about bedtime is that recently I've been pretty exhausted by the time I make it into my bed. Never before has it been a struggle of any sort to walk to my bedroom. And I would say that my mood reflects the emotional and physical exhaustion that I feel by the end of the day.

The wonderful thing about sleep is that it makes me forget about the frustrations and troubles of the previous day. I wake up and look outside at the beautiful world. Perhaps it the sun is starting to rise (it's actually been pretty sunny lately) and I can hear the twitter of birds nearby. Or perhaps there's a thick, mysterious fog. Or maybe I hear the pitter-patter of rain on the roof. For whatever reason, I've relished the mornings since surgery more than before. Maybe it's those extra 5 seconds that I spend looking out the window before I summon the energy to rise from my bed. Whatever the reason, I'm thankful that I have a nice neighborhood to wake up in.

Dreams of Feet

Most of my dreams since surgery have involved feet in some way. Or at least, this is true about the dreams that I can remember the next morning. I would attribute this to the simple fact that it's the biggest issue I deal with on a daily basis and what I think about the most. This may be a sad reflection on my priorities, but I don't think it's too surprising given that I'm a runner who's always looking at her feet.

Here are some recollections of my dreams:

• A few days after surgery: I dreamt that my mom had convinced me to take off the cast early so that I could look at my foot.
• In the first week after surgery: I dreamt that the cast came off and my foot was PERFECT. Like the foot of a small child before it's had a lifetime to collect injuries and scars. I woke up very happy after this dream. I'm not sure if I had had vicodin just before bedtime...
• Also in the first week after surgery: I dreamt that the cast came off and my foot was hideously deformed, worse than before surgery.
• A couple of weeks after surgery: I dreamt that I was walking on my left foot, with the boot on, before I was supposed to. And then I had to go up a set of stairs, which was when I "remembered" that I was supposed to be on crutches, which I had left in the car.

These kinds of themes have been recurring. It's hard to generalize about what I "normally" dream about, but a few times I've had dreams about chasing someone or being chased. I've also had dreams about forgetting shoes for a race. I suppose these are fairly runner-oriented as well. :)

My Favorite Places

I've realized that recently my bed has become my favorite place. Perhaps it's because that's where I get to take off my boot be a normal person for a few minutes before I fall asleep. I really do enjoy it more than I used to.

Other places where I get to resemble a normal person are in my office at work, in the pool, and in our kitchen at home, where I've placed an armless and backless rolling chair to enable me to roll around. Unfortunately, the rest of the house is carpeted.

Cold

It's hovering right around freezing this morning, which isn't too unusual, but on the chilly side for Seattle. What I'm wondering is who thought that metal crutches were a good idea. Brrr!

Carrying Capacity

Carrying things is one of the hardest parts of being on crutches. I can't really carry anything bigger than a (small) set of keys in my hand while maneuvering about.

I've read that bags that attach to crutches don't work so well because they throw you off balance and that a backpack is really the way to go. I'm wondering if this person has ever crutched around with a backpack.

In all fairness, it's not too terrible, and a million times better than, say, trying to carry a grocery bag while on crutches. (It really is amazing how much that will throw you off balance.) But think about it: the shoulder straps of the backpack are exactly where the crutch under-arm pads are supposed to be. This effectively makes the crutch-user taller which may require adjustment to the crutches. Or just make the whole experience less comfortable. And try getting something out of a backpack while standing on one foot. Warning: this usually involves a lot of hopping.

When presented with a large load (groceries, etc.) the backpack does seem like the best way (or an electric cart or sherpa-friend), but here are some other alternatives that I've enjoyed:

1. The fanny pack. No interference from the shoulder straps. The "everything-I-want-is-behind-me" problem persists, but it's sometimes manageable to rotate the pack around to your front whilst standing on one leg.
2. The bicycle jersey. Available in long or short sleeves from your favorite cyclist's closet, it's pretty handy and much sexier than any fanny pack. Three fun pockets to choose from, if you don't mind fumbling when reaching for your back.
3. (My favorite) The green hooded sweatshirt. Adam Sandler preferred red, but I went to Dartmouth... Its beauty is in its simplicity. You can fit contained food items, water bottles/ soda cans in it, all while enjoying its snuggly comfort. Good stuff!

Gimpy Goes to the Game

Thanks to Scott Hanggie's generosity (he's a coworker of mine in Flight Sim), I got to go to the Sonics game last night with his season tickets. Scott was sick with the flu, so I brought my friend Dave Hunt, a runner who works in MSN Money and who happens to like basketball too. We hadn't seen each other in a while (a few months, I think), so it was fun catching up and talking about things other than running, too. We both suspect that our current injuries (his knee and my foot pain) are related to the hellish downhill run that we did at Ski 2 Sea last year (Memorial Day, 2004).

At the game, getting down the stairs to row 8 (from row 24 or something like that) wasn't too tough, but once there we realized that getting into seat 12 was going to be pretty much impossible. You know how hard it is squeezing by people you're sitting next to at a movie theater, baseball game, etc. Now picture doing it on one leg. To make things even trickier, the seat backs at Key Arena recline, so they aren't a very stable crutch.

At the suggestion of the woman sitting at the end of row 8, we took a couple of empty seats in row 6 that were on the end. We were surprised that no one came to claim them during the game... until 8:30, midway through the 3rd period, when a disgruntled woman and her companion huffed that we were "in her seats". So we moved over to the left and made room for them. All in all, it worked out just fine, but that woman (who was later shouting obscenities directed at the referee) wasn't the most understanding or forgiving soul I met yesterday.

As far as the actual game went, the Sonics crushed the Hornets, who seemed to have a preponderance of young white guys both on and off the bench. It looked like Squatch beatered on a railing when going down stairs on stilts. (We only saw the aftermath, not the actual incident.) That guy, whoever he is, is amazing.

The other challenge of the evening was getting back up those 18 steps. What a nice lactate burn I had!

Special thanks to Dave for missing part of the game to fetch food for me and again to ScottHan for the sweet tickets.

Top Ten Things I Like About Being on Crutches

Here's a little list to balance out the negativity of some of my recent posts:

1. Getting to park in the spots closest to the front door of our building (i.e. the handicapped ones)
2. Knowing exactly where your parking spot will be (i.e. the handicapped ones)
3. Being able to get your carload of friends to the best parking spots (i.e. the handicapped parking).
4. Free metered parking (ala handicapped parking tag)
5. I can close my office door without having to move from my chair.
6. Buff arms and shoulders (no joke).
7. EVERYONE (ok, almost everyone) will hold the door for you. Some people will go 50 feet out of their way to open the door for you. Just watch out for the people who try to 'help' by opening the door that you're leaning against for support.
8. The most sure-fire conversation starter ever. (Although escaping from a conversation about the amazing healing effects of naturopathic medicine X can be difficult)
9. Having an excuse to try different things (like, say, watching TV and hanging out with friends) because you can't run and bike as much as you usually do.
10. Did I mention that I like the handicapped parking tag?

Mine!

It's funny, but I've developed a bizarre sense of ownership of certain places. For example, "my" parking spots outside of Millenium F. If I think that someone has parked in one of the three handicapped parking spots outside of the building that I work in, I start to get offended... but then I realize that they're just parked in the visitor spot next to them. And when somone was in the handicapped stall in the women's bathroom, I felt a little annoyed. And the funny thing is that I don't even really need the handicapped stall!

And then there is the elevator at the Pro Club, which I also have come to think of as my own. And I find myself somewhat judgemental of those people I see who don't have any visible disability getting out of the elevator. "Don't they need the extra exercise?" I think to myself.

I think I am just becoming a selfish sissy!

Spinning

I find it amusing that a spinning class can either involve old ladies working on a craft or athletes sweating their brains out, depending on context.

Anyway, the spinning class with a Bledsoe brace actually worked out just fine. Next time I'll make sure I have an SPD cleat in my right shoe. And ideally I would add an inset into my boot where an SPD cleat could fit... but I might just be lazy and go without.

I had forgotten that spinning classes usually involve "jumps" or getting out of the saddle. I skipped those, but still got my heart rate up to 170. By the end it was generally hanging around 160, and for the majority of the class it was over 150 (except for longer rest periods). All in all, it was a pretty easy way to get in a good workout, so I'll probably try to go a couple of times per week.

You can see the dent left by an ice cube in my foot. The swelling was probably caused by some intense physical therapy on Friday. The picture was taken mid-day Sunday. 

Sunday: a day of friends

In the morning, Heather and her boyfriend Greg stopped by on their way out of town. They're driving to Jersey to bring Heather and her boat back to the east coast after a stay in Seattle for training in rowing. We had a nice breakfast complete with blueberry pancakes, eggs, and blueberry muffins. They also helped take out the recycling. :)

In the afternoon, Steve Chang came over and helped me run errands and carry some things around the house for me. I was pretty excited about the tulips and daffodils that I bought at Safeway.

I took a little nap after Steve left before heading over to the Pro Club to aquajog with Ramesh, a runner from Microsoft who has a stress fracture in his foot. Afterwards we headed to Udupi Palace for a delightful Indian meal. Ramesh helped me figure out what to order and how to eat it.

I think I had a good workout (HR steady around 150 and up to 164), as I slept soundly for about 9 hours last night.

I've decided that weekends are the hardest part of being on crutches; they're when I'm typically most active, and it's frustrating to try to do a fraction of what I normally do. An exercise in patience for sure!

Gimpy Goes to the Post Office

If you want to go through an exercise in pain and frustration, try this:

1. Go to the post office on a Saturday morning with crutches and 2 smallish items to ship
2. Try to pack those items while standing on one leg
3. Crutch to the back of the line with the large-ish "priority mail" box (you know what I'm talking about)... of course, since the box won't fit in your backpack and you'll be trying to fit the box between the crutch and your side, each step you take will be limited to about 6".
4. Stand in line on one foot (there isn't anything so big as a window ledge to sit on, even if someone did volunteer to stand in line for you) for 15 minutes or until you're ready to cry, whichever comes first. (though note that if you go for the 2nd option, you'll just have to start back at #1 on another day)
5. On your way out, notice that no one in the post office has said a single word to you or offered any kind of assistance in any way.

Crutches: Slippery When Wet

I could probably write volumes about crutches by now, but when I'm not actually using them (e.g. sitting at my desk in front of my computer) it's hard to remember all the issues. But here's an example from today: when I was showering at the gym this evening, the bottoms of my crutches got a bit wet. However, I didn't even notice until I almost wiped out on the RIDICULOUSLY slippery floor in the main hallway of the Pro Club. I mean, it's like they're TRYING to kill their customers. I've noticed a similar problem when my (running) shoes were wet, but this was worse because a crutch would actually fly out to the side. It actually happened 4 times in a span of about 25 feet of walking? You're probably wondering why I didn't just dry them off after the 1st time, but I DID try after the 2nd... and you try drying the bottom of a crutch in the middle of an open space on one leg.

Down

In the roller coaster of post-op recovery, I'd have to say that today was one of those low points. My foot was very swollen (the worst I've seen it in a couple of weeks), but I had promised Chris that I would work at the bike shop from 1-7. But by noon I was already exhausted and frustrated after a trip to the post office, drug store, Circuit City, and the craft store. So hi-ho-hi-ho it was off to the shop I went, followed by a workout at the gym. For some reason I had a hard time getting my heart rate up. By the time the cop pulled me over for having expired tabs (or rather, for Brett's car having expired tabs) at 9:30 p.m. I had pretty much had it.

Man, I could really use a day just to lie in bed and sleep.

Atrophy

I expected to lose strength in my left leg, but I didn't expect it to be so visible! After one week, my left calf was .75" skinnier (in circumference) than my right. After 3.5 weeks, the difference was up to 1.5". Poor little leg.

Workin' out

People keep asking if I can work out, and the answer is yes! In fact, this morning I did my first real aqua-jog. I swam twice last week, but I like aquajogging because it allows me to really BREATHE as much and as hard as I want, which I think allows my heart rate to go up pretty high. I haven't officially tested this theory with a HRM (heart rate monitor), but a couple of quick pulse checks registered at ~160 bpm (beats per minute), so I feel pretty good about the workout. It was only about 40 minutes, but the time went by relatively quickly. I'm pretty fortunate that our gym (the Pro Club in Bellevue) put in a new pool last year that has an actual deep end. Otherwise the workout wouldn't have been possible there.

The last workout that I did prior to this morning's was on Monday, when I got on the stationary bike for about 53 minutes. I was pretty happy that I was getting up to a heart rate of about 170. In a real trainer workout/spinning class I would probably get into the 180's a few times, but considering that I'm still very gimpy, I was quite pleased. On Sunday I was on the stationary bike as well, and also played around with various nautilus machines (upper body) that I haven't used before. Late at night (less than an hour before closing time) is a great time to try out different machines, as the machine:user ratio was somewhere around 10:1 - 20:1.

Physical Therapy begins

Yesterday (22 days post-op) was my first appointment with Shelley Hack, PT, at the Pro Club. I came away quite pleased and looking forward to our future appointments (twice a week for 6 weeks). Currently she's just supposed to be working on improving the range of motion in the 1st MPJ (the joint that connects the toe to the foot). But we also worked on getting the swelling down via massage and ice. She instructed me to stretch my Achilles, as it will likely get even TIGHTER than it already is due to the enforced post-op immobility. She was strong but gentle and my foot is feeling even more normal after seeing her.

One reason that I chose Shelley from the host of physical therapists at the Pro Club (which is the local foofy gym near Microsoft) is that I had recognized her name from race results. I don't think we had ever met before, but she has many years of running experience and is quite a talented and accomplished runner at that! Apparently she made a bit of money through running during her collegiate years. I look forward to hearing more about it in the weeks to come.

Doc is happy

Because I was concerned about possible regression, I managed to get into Dr. Maurer's office today (it had been a week and a half since they last saw me - I'm sure they missed me). He said he was really very happy and quite pleased with the progress and "state of the foot" as it were. And he was happy that I came in - he said he would have woried about it until he saw me again if I hadn't. He even took the steri strips off a bit early and was impressed by how fast my skin had healed.

So, the summary is that the straightness of the toe post-op was expected to diminish over time. The slight crowding of the 2nd toe that was happening earlier this week was probably due in part to the tightness of the compression sock that I was wearing. Now that I've trimmed it back so that it doesn't reach my toes any more, I should be good.

Also, Dr. Maurer showed me how to tape down my big toe so that the skin doesn't tighten and keep the toe off the ground.

Current foot exterior. The bruising on my toes is almost completely gone, and the incision is healing really well. 

X-ray one week post-op. Yes, that is a screw in there. Note that thought there was a wedge of bone removed, the bone was not completely severed. 

Regression?

Am I being paranoid or is my bunion making a comeback? My big toe used to be perfectly straight (I noted this two weeks ago when my foot came out of the cast), but no longer - since the swelling has started going down the big toe has been moving closer and closer to the 2nd toe.

Today was my first day of physical therapy and when I mentioned it to the physical therapist she said I should call my surgeon. So I did (and left a message). I'm anxiously awaiting a reply. Apparently during the 4th week of healing things tend to really settle into place, so if we could fix the problem now, it would be better than waiting.