Monday, November 30, 2009

The Cut that Won't Go Away

The one area that continues to cause me some grief as I continue my recovery is the place where they cut the skin. It is just a tough area of the body to get healed I guess. Applying Neosporin whenever I have the chance seems to help as does keeping it unwrapped and exposed to air whenever I don't have to wear a shoe. During the day, I've been wrapping it in 4 inch gauze and tape, however last night I got some of those oversized band-aids which seems to cover the wound pretty good and is a little less of a pain to apply. It still doesn't look all that pretty, but there are no signs of infection and it is improving, so I guess I'll take that for now.

The flexibility of the joint is improving as well. I can now confidently say that I have better range of motion post-surgery than I did prior to the surgery. Prior to surgery, if I used all my physical and mental strength, I could lift my big toe high enough to slide a piece of paper under it. Maybe two pieces on a good day. Today, I could probably slide a 300 page book under there. Soft cover. While that may sound impressive (or it may not, I have no idea), there is still work to be done with my toe exercises. The doctor said that you basically have 6 weeks post-op to get as much range of motion back as you can. After that, you're not going to improve much. So I'm trying to stay diligent with them, which isn't always easy.

As far as running goes, I didn't run at all since Thanksgiving until today when I did 5 miles on the treadmill. The toe joint felt the best that it has in a long time...probably even before the surgery. There was absolutely no pain in there for the entire run. However, when I finished, I did have a strange pain behind my knee, which could have possibly been caused by some over-compensation that I didn't realize I was doing. It subsided after a little stretching, but it is something I need to keep an eye on.

So for now, things continue to progress. If you'd have told me that I'd be running pain free only 3 1/2 weeks after the surgery, I would have been thrilled. The goal is still to be able to handle a marathon build up by the 1st of the year, so everything I do between now and then is in preparation for that. I need to keep reminding myself of that though so I don't overdo things. I have a tendency to do that.

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Thursday, November 26, 2009

Happy Thanksgiving - Day 20 Post-Op

I'm extremely thankful for the 3 miles I was able to slog through this morning. It was my first run outside (on concrete) since the surgery, and while I still have a ways to go to be able to handle a true marathon build, I'm gaining confidence that in another month I'll be there.

I'm continuing to work on my toe exercises, which are just range of motion of bending of the toe. It isn't too painful and I actually have better ROM now that I did prior to the surgery, which is encouraging. If there is one nagging thing it is the incision, which continues to be a pain in my, err, foot. While it has improved, it continues to annoy me when pretty much anything rubs up against it. That's OK during the day, but at night, I've been waking up far too often as I bang or rub it against the bed throughout the night. I never even considered that the incision would be a consideration in the recovery process, but it is definitely proving to be the biggest area of concern.

Happy Thanksgiving to everyone!

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Monday, November 23, 2009

Pictures, Neosporin, and Turkey Trots - Day 17 Post Op

I had somewhat of a set-back on Friday night. I unwrapped my foot when I got home from work and was kind of alarmed at the condition of the incision. It was oozing some liquid and it was discolored and generally disgusting looking. Well, I mentioned earlier that I might post some pictures, so this seems as good a time as any.

Yeah, not pretty. So after getting some expert opinion on how to care for the foot, I pretty much ignored it all and just went to bed. The next morning, after seeing no improvement, I started putting some Neosporin on the cut prior to wrapping. I was told this wasn’t the best idea as it can cause allergic reactions in deep cuts, but I’m too big of a wimp to even think about alcohol swabs. The Neosporin did seem to help, so I’ve continued to apply Neosporin and change the wrap about twice a day since then. It has greatly improved and seems to be healing much nicer now. However, because of the bad condition of the foot, I decided not to press my luck and did no running or any real form of exercise all weekend long.

Then today, I decided I needed to sweat, so I went to my gym at lunch and remembered that they were having a “turkey trot” today. Basically, what it consisted of was running 3.1 miles on the treadmill and one of the trainers recorded your time. Fastest time of the day wins a prize. No mention of what the prize is, but I’d imagine it’s something I can’t live without, like a cheap cotton t-shirt and some energy drink mix.

Anyway, I really wasn’t planning on doing it, but once I got into the gym area, there was a big sign up that said “BEST TIME OF THE DAY: 18:19.” Then the ego took over. I went over and asked about it, got the run down on the finer details from the instructor and climbed on a treadmill. The instructor punched in the workout and said, start whenever you’re ready. Well, I was at least expecting a warm-up, but figured, I’m not here to kill myself, so mile 1 will be my warm-up. I started at 10MPH and slowly crept up throughout the first mile and finished in 5:50. I was feeling fine cardiovascularly and the foot was holding up great, so I pushed a little on the next mile and did mile 2 in 5:20. The foot was still fine, but I’ll admit that my breathing was getting a bit labored. I have run exactly 3 miles in the past 20 days so I guess it should have been expected. However, I decided no guts, no glory and continued to push the pace finishing with a 5:12 mile and a 17:01 overall run.

Most importantly, the foot held up fine. It was a little sore after I showered and but it has since calmed down and feels good now. The cut area also held up fine with no additional bleeding from the hard running. Overall it was a success. Now I just have to sweat out the next 10 hours to see if a 17:01 will hold up, allowing me to claim the lucrative prizes. I’ll keep you posted.

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Friday, November 20, 2009

My First Run in 2 Weeks

I actually got up my nerve today and climbed on the treadmill for 3 miles of running around a 7 minute pace. The results were pretty encouraging. The toe joint itself held up just fine. My biggest concern and biggest source of discomfort is the place where they made the incision on the side of my foot. That area is still very tender and I'm a little nervous about splitting it back open. However, it held up fine today, which is encouraging. Hopefully as the air continues to get at it, it will toughen up and speed up the healing process.

I'm still having problems walking without a limp, again due to the discomfort around the incision. However, for whatever reason, things feel a bit more natural when running. I do have to keep a watch out for weird sore spots though, as the fear of over-compensation is always there. I'd hate to hurt a hip by pushing things too quickly.

If you would have told me that I'd be able to run for 20 minutes only 2 weeks removed from surgery, I probably would have done this a long time ago. I know I'm not all the way back yet, but so far things continue to progress about as well as I could expect them to.

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Thursday, November 19, 2009

Day 13 - Phase 2 Begins

I handle pain pretty well. What I don't handle all the great is the anticipation of pain. I get nervous when I need to get a shot. I get nervous before I have to do a hard workout. Heck, I get nervous before I jump into cold water. So, I'll admit that I was looking forward to, and dreading, today's visit the doctor, where I was scheduled to get the stitches removed.

Of course, the actual removal turned out to be no big deal. It didn't hurt at all, except for a few little tugs and it was over in about 2 minutes. I still managed to work up a pretty good sweat as I was sure that as each new stitch got cut, the student assigned to the task would surely lop off half my toe.

After that was done, the doctors came in to give me some instructions for the next few weeks. They said I can start wearing a normal shoe immediately, and as far as everyday activities, let pain be my guide. They said I do need to be careful, as there is some healing that still needs to be done to the underlying tissue, but didn't give me any hard restrictions.

They also said now is the time to really start working the toe. They didn't give me a script for physical therapy yet, but said if they don't see progress when they see me next (in 3 weeks), they will have send me at that point. For now, I'm on my own though, which I like. With 4 kids at home, making time for PT would be difficult. Again, they said let pain be my guide with the toe exercises as well, but in this case, I want it to hurt. The doctor actually said "no pain, no gain" so hopefully I can make it hurt. We'll see.

As soon as I got back to my desk at work, I quickly took the boot off and put my shoe on. I'll admit it felt weird. After having no pressure on the top of my foot for almost 2 week, it was a new sensation to now actually feel something up there. However, despite being pretty tentative, there is no real pain when walking in a regular shoe, which is encouraging. I think I mainly need to gain some confidence for a day or two and then things will be close to normal. At the very least, there are no more bag foot showers, which is definitely a gigantic step in the right direction.

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Monday, November 16, 2009

10 days Post Op

Another encouraging couple of days as the comeback is definitely on at this point. I spent most of Saturday on my feet (and on a ladder) painting the front entrance to my house and the foot held up fine. My 6 year old daughter called me nuts a few times, but other than that things went off without a hitch. I have now completely weaned myself off of the painkillers. During my check-up last Thursday, the doctor mentioned that I had a lot of bruising around my heel and she said it was most likely due to me taking Ibuprofen and elevating my foot. So in an effort to get rid of that (and since there is no noticeable swelling in the foot anymore), I’ve decided to just try and stay away from Ibuprofen for the time being. Probably not coincidentally, the bruising has also gone away.

If it wasn’t for the stitches in my foot, I’d probably be tempted to go out for a run at this point. That’s easy for me to say, as I know it isn’t an option since I cannot get out of the walking boot until the stitches are removed, but at the very least it doesn’t seem like crazy talk. That’s a start. As an alternative, I went to the gym today and did 5 minutes on the bike and couldn’t take it anymore so I moved over to the elliptical for a half hour. While it’s definitely not the same as running, at least I was standing and moving my legs. I really felt it in my quads more than I ever have running so I know it’s working different muscles, but it’s probably a little more specific than biking was. I’ve also realized that between my fashionable walking boot on the elliptical and then plastic bags that I have to wrap my foot in for the shower afterwards, I’ve pretty much lost all self-esteem. Oh well. Easy come, easy go.

I noticed today at my gym that they are having an indoor “Turkey Trot” next Monday. It’s basically consists of running a 5k on the treadmill and then reporting your time to a trainer when you’re done. Top runner gets some sort of prize. While I realize it’s probably pushing things and not very smart, I’m tempted to target it. Luckily, I don’t have to decide anything right now. I have a few more milestones before next Monday. Like the stitches coming out on Thursday and possibly wearing two matching shoes for the first time in a couple weeks. Thank God for life’s little joys.

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Friday, November 13, 2009

One week later

Things continue to move in the right direction. Wednesday was my first day back in office, and I was a bit nervous about the long walk from the train to my building. It took a long time, (25 minute walk instead of the usual 15 minutes), but I made it. My foot was sore when I finally got into the office, but it wasn't so much from the surgery but more from the overcompensation. My ankle and knee actually hurt worse than the toe. The walk back to the train was a bit of a pain as well, but I made it.

Thursday was more of the same, but the walk was much better and if I didn't have a gigantic boot on my foot, you probably wouldn't even know that I had surgery 6 days ago. The limp was almost completely gone and other some occasional shoots of pain, things felt good.

I then had a check-up around noon to get the dressing changed and I had my first look at the scar on my foot. It wasn't pretty. It's about 3 inches long and all discolored and scary looking. I should have brought a camera to take a picture of it. A medical student was the first one to look at it and he said it looks healed and I think we'll take the stitches out today. Now if this thing was healed, I hate to see what it looks like when it's not healed. Luckily the doctor could come in before he could get his scissors out and put a stop to this crazy talk. The stitches will come out in one more week.

They took xrays and compared them to last time and things look good. It's a little weird seeing a staple in the middle of my toe, but it's small and hopefully I'll never know it's there. They rewrapped everything and sent me on my way, and for some reason, my foot hurt like crazy the rest of the day. Maybe it was just the exposure to air or something.

Today things continue to improve and when I realized I was late for the train this moring, I actually ran, with my boot on and all) the half mile to the train. The people on the street probably thought I was a bit nuts, but it didn't really hurt. Then at lunch, I hit the gym for a 30 minute ride on the stationary bike. It was the first physical activity I've done since the surgery and it felt great to finally sweat. Again the foot held up fine. I'm hopeful that in one more week, once the stitches come out, I'll be ready to do some easy running on this thing. So far, things are going great.

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Marathon Progression

10/1998 Chicago Marathon: 3:35 10/1999 Chicago Marathon: 3:03 4/2000 Boston Marathon: 3:10 10/2000 Chicago Marathon: 2:51 4/2001 Boston Marathon: 3:25 10/2001 Chicago Marathon: 2:51 5/2002 Lakeshore Marathon: 2:57 10/2002 Chicago Marathon: 2:54 6/2003 Grandmas Marathon: 3:35 10/2003 Chicago Marathon: 3:01 10/2004 Chicago Marathon: 2:48 10/2005 Chicago Marathon: 2:46 12/2005 Tecumseh Trail Marathon: 3:21 4/2006 Equestrian Connection Marathon: 2:45 10/2006 Chicago Marathon: 2:38:21 4/2007 Equestrian Connection Marathon: 2:40? 10/2007 Chicago Marathon: 2:45 10/2007 Lakefront 50/50 Marathon: 2:45 4/2008 Equestrian Connection Marathon: 2:36:15 10/2008 Chicago Marathon: 2:41:25