Wednesday, April 16, 2008

One ugly foot

As promised, I unwrapped my foot and removed the gauze so I could get a photo for the blog. Swell looking foot, huh?

Dr. Thomas said that the large red area is kind of a subcutaneous blood bruise. The bruised toes are a nice touch, too, as if the incision wasn't nasty enough.

I got good news from the doc yesterday afternoon when I called him with some followup questions:
  • I can now get my foot wet! That means I can finally shower (I had to take baths before - there's another funny picture that won't make the blog - my 6'3" frame stuffed into a normal sized bathtub with my lower left leg & foot hanging out the side). Last night's shower was fantastic. I even figured out how to rebandage & rewrap my foot afterwards.
  • I can now ice my foot, which I have done a few times since getting home last night. That should help reduce some of the swelling that runs throughout much of my foot, and should help it feel better than even the vicodin or ibuprofen.
  • I can exercise with my walking boot on! I rode a LifeCycle R9i recumbent bike for 10M in 30:56 yesterday at the store. All I had to do was remove the pedal straps, and I was all set. I think I could probably use an elliptical machine, but it might feel a bit awkward as the boot doesn't let my foot/leg move the normal way (that's kind of the point). The boot is mainly really nice as I can feel a lot more comfortable walking around and not worrying about my foot.

All that said, my foot hurt more last night than at any time since the surgery. My good news this morning is that I weighed in at 182.0 pounds. I was 181.8 pounds a week before the surgery, so I survived a period that I could have very well added another 4 or 5 pounds.

Tuesday, April 15, 2008


As a runner, my feet are rarely pretty looking. And when my training and racing has included marathons and long trail races, they look decidedly worse. But damn if my left foot isn't the ugliest fucking thing I've seen in awhile! I got a good long look at it this morning for this first time since surgery. I should have taken a photo and used it for the main blog photo - I've heard that's the cool thing to do...

I guess the surgery went well. That's what Dr. Thomas told me. Here's a recap of the past several days:
  • Thursday 04.10.08 - I started the day off with 4M on the elliptical (36:58), knowing I wasn't likely to get in a workout later that day, and maybe not for awhile after. My mom and I arrived at the Foot Surgery Center of Northern Colorado a little after 9 am. Everyone was very nice that morning, but it did take 2 tries to get the IV started (yippee!). I then met the anesthesiologist, who explained her process, and I headed into the operating room. They started the medication into the IV, I asked someone if they could prop up my arm a bit as the IV was bothering it, and then I was in the recovery room. Bizarre. I didn't even see my doctor until afterwards. My mom drove me home, and while I was prepared to be out of it then and for the rest of the day, but I seemed fine. After a late breakfast (couldn't eat before the surgery), I headed upstairs for a nap. I noticed that there was a fair amount of blood saturating the dressing. Great. I decided to go ahead with the nap (I rarely get the opportunity) and called the doctor's office afterwards. "Can you be here at 9 am tomorrow?" Sure, what's another trip to Ft. Collins. The bleeding didn't seem to continue, and I didn't really have any pain that day. I tried to sit around with my foot elevated most of the day. I took a couple of vicodin and took it easy.
  • Friday 04.11.08 - Back in the car, my Mom drove me back to the doctor's office, and Dr. Anderson (Dr. Thomas' partner) checked out my foot and said it looked OK. He had the dressing changed, and we headed back home. More lying around with my foot up. I was able to walk around using my right foot and left heel, as the left foot was somewhat protected by a surgical shoe. Later that day, I was able to exercise. I "rowed" 5K on my Concept II rowing ergometer, using my right leg and both arms. It took me 22:56, wheras a normal easy row for me would take under 20:00. The streak continued. I ate a couple more vicodin per doctor's recommendations to not wait for it to really hurt.
  • Saturday 04.12.08 - More of the same, another 5K of one legged rowing (23:22), still not much pain (only took one vicodin).
  • Sunday 04.13.08 - Lifted weights for 31:00 while watching the London Marathon (wow!) on the computer. I haven't read a whole lot on it, but I'd say he's easily the best American marathoner ever through 3 races. 1st, he ran an American debut record in a tough, fast race in London ('07). 2nd, he dominated the Olympic Trials in NY with a Trials record and fast time on a rolling course. And 3rd, he ran 2:06:17 in London, surviving a scorching early pace to place 5th with the best American born performance EVER in an amazingly fast race. More lying around, yada yada yada. We had friends over for pizza, and later I headed out to DQ for a Blizzard.
  • Monday 04.14.08 - Back to work, keeping the foot up much of the day (we were SLOOOOOOOOW). 30:00 of weights. My foot started hurting more, and I only took one vicodin before heading to bed.
  • Tuesday 04.15.08 - Drove to Ft. Collins for my first official Post-Op appointment. The assistant took off the old dressing and left me there to stare at my foot for several minutes before Dr. Thomas came in. As I looked at the incision, and the bruised and bloodied foot, I wasn't bothered by the "ickiness" of it. It didn't make me feel nauseous. It made me worry about "getting back" and really running again. I really don't know if my foot will work right in the future, and staring at my hideous foot brought that home. I guess we'll see... So Dr. Thomas examined my foot and re-dressed it, and then had an assistant get me set up with the walking boot. It's nice to be able to walk more "normally" - much better than the surgical shoe. I took some ibuprofen awhile ago, as I'm having about as much pain as I've had. I may try to use an elliptical machine a little later - whatever I can fit this boot onto.

Wednesday, April 9, 2008

Sesamoidectomy tomorrow

So it's been awhile since I posted. I need to get into a regular habit of blogging. I've been out of sorts for, oh, a long time now. I've managed to still be a creature of habit in one way, but that is currently being threatened.

I've worked out everyday for the last 10 years, and 2 1/2 months. I'm having foot surgery tomorrow, and while I'm hopeful that I'll be able to continue some type of workout, it's not a sure thing. Stay tuned...

So, yeah, I'm having a sesamoidectomy on Thursday morning. My podiatrist, Dr. Michael Thomas of the Poudre Valley Foot & Ankle Clinic and the Foot Surgery Center of Northern Colorado (who I've been seeing for my foot issues for the last 12 years) will be performing the surgery. I'm having the fibular sesamoid in my left great toe removed, as it has likely been stress fractured for at least the last 2 years. Oh - you HAVE to click on the above link to see the picture of the 70's guy running in vintage Nikes and long 3 stripe socks. Wow.

Some more info on the surgery and recovery:
  • There are 2 sesamoid bones in the great toe joint. A sesamoid bone is basically a "floating" bone that adds stability to a joint. I'm having the fibular sesamoid bone in my great toe joint's flexor tendon removed. So it's the sesamoid bone to the left in my big toe (closer to the rest of the toes).
  • One of the likely side effects is that my big toe will drift away from the other toes (don't laugh - it will remain attached). My doc tells me that's OK, as wearing a shoe keeps the toe in line. He said this bone being removed is slightly more work for him, but it generally has a better outcome for the patient. With the other bone removed, the big toe moves toward the other toes, which can lead to bunion problems.
  • One of the risks during the surgery is that he could cut my flexor tendon. That would be bad. Dr. Thomas said he hasn't done it yet, and he's performed hundreds of these surgeries. So that's some reassurance. Unless you're a half empty type, then he's due...
  • I'll be undergoing IV sedation, so I won't be going completely under. Apparently, one of the drugs I'll be getting has an amnesiac quality, so I'll be foggy and won't remember much. They'll also administer a local anesthetic to my foot, so I shouldn't have any painful memories anyway.
  • I find this funny (but I do get it): One of the items on the consent form states "I realize that impairment of full mental alertness may persist for several days following the administration of anesthesia, and I will avoid making decisions and taking part in activities which depend upon full concentration or judgement for at least 24 hours." And they mentioned this a few times - no important decisions for the first 24 hours.
  • I was able to convince my mom to fly out here from Illinois to help out (and help watch the kids next week while our nanny is gone). It will be nice to have her out here for this whole deal, and she'll be driving me back from the surgery. She's also a retired nurse, which adds some reassurance for the recovery process.
  • The initial recovery consists of mainly staying off my feet most of the time. They've recommended I stay off my feet with my foot elevated 12" above my waist at least 45 minutes out of every hour. I'll be wearing a surgical shoe and they recommend icing my foot on and off for 2o minutes for the 1st 4 hours after surgery, and as needed after that based on pain. Oh, and there's vicodin for the pain. And even more fun - if I have nausea from the vicodin, I have anti-nausea anal suppositories. I'm not planning on any nausea. I don't get any crutches, and Dr. Thomas said I should be fine to walk around as long as on the left side I only use my heel. And while I can't shower for the first 4 days, I am able to take baths with my left foot hanging out of the tub.
  • I'll see Dr. Thomas to have the dressing changed on Tuesday 04.15, and at that point I'm supposed to get a walking boot that will allow me to get around a lot easier. I think I should be in that boot for 2-3 weeks. I think as soon as the boot comes off, I can return to 2 hour trail runs, track workouts in spikes, and 80 mile weeks.
  • He told me I should be able to return to running somewhere in the next 6-8 weeks. Right now, I don't feel particularly anxious to jump back into it. I haven't run since early December - what's a little longer? Plus, I have plenty of cross-training options in my basement (Precor elliptical machine, Concept II rowing machine, Sportsart recumbent bike, etc.) and at the store (everything else) to keep me relatively fit. It will be based on how everything feels. I'll start with the treadmill, and eventually head to soft, even trails. I asked my doctor what should be easier on my foot, and what will be harder on the foot. He recommended initially focusing on distance over speed, soft controlled surfaces over roads and technical trails, and no track workouts. Makes sense.

So, back to the workout streak. I know I could (and may) just let it go. But the streak has gotten me out the door, or down into the basement, many times over the last decade. And we're only talking the first 4 days - after that I should be a little more freed up with the walking boot. A couple of my options:

  • Rowing with one leg. I just tried playing with this in the store, and I can probably make it work.
  • Weightlifting - I have dumbbells, a fit ball, exercise tubing, etc. which could work.
  • One legged elliptical is NOT going to work (tried it), and the treadmill is out.
  • Recumbent bike as an upper body ergometer type exercise. I just tried that, too, and while I don't know how long I'd want to do it, it's certainly a possibility.

As you can tell, I'm leaning towards keeping the streak alive. But I am reminded of what my urologist said before my last surgery: "We always tell everyone to take it easy after the vasectomy, but one patient had planned some rock climbing and didn't want to back out of it. He was back in the office with a scrotum the size of a grapefruit."

It's always good to close with a scrotal reference. More later...