Shots shots shots shots!

Not the fun shots.  Not the shots at the bar.  Needle shots, and lots of them :(

Given I am at an elevated risk for developing a clot due to a genetic deficiency, my doctor put me on blood thinners for pre and post surgery, and referred me to a hematologist to ensure we did everything correctly.  This is how that conversation went:

Doctor: So basically, your leg is immobile, which increases the risk of developing a clot - like when you fly.  On top of that, you already have a risk.  So I'm going to put you on a medicine to help mitigate that risk.
Me: Ok.
Doctor:  Ok great, it's an injection.
Me: Ok.  Wait what??

I started off once a day, but at the hematologist's recommendation, dosage increased to 2x a day.  Quick calculation and I'm just shy of 60 self-injections.  When I picked up the prescription, the pharmacist walked me through the "how to".  She said, "Don't worry, it's just a tiny pin prick.  Teeny tiny needle."  Basically I pinch my stomach "love handle" and stick the needle in, then do the injection.  I rotate sides and locations to  minimize bruising and marks.  I've also learned to fully let the alcohol from an alcohol swab to fully dry - else it burns as the needle goes in.  

Oh hi, needle.

In the grand scheme of needles, I can definitely argue this is a small needle.  But when self administered straight into your stomach, it is nowhere near a teeny tiny prick, and definitely took some nerves for the first few shots.  I don't even think the needle made it under my skin for the first go round.  Honestly, I was expecting that little needle they use to prick the end of your finger - not this.

In the next few days, I can dial down to one shot a day.  I will no longer need to dread 9am and 9pm! And after this ordeal, I can remind myself how fortunate I am that I do not have a condition (like diabetes) that requires a lot more needles.  I'm also looking forward to getting back to my old definition of "taking a shot".
 

Rules for Recovery

I've just flown into the 3 week mark at 25 days into recovery!  As time has passed, I've found it significantly easier to deal with the injury.  While Weeks 0-2 were heavily peppered with tears, exhaustion, and questioning "why", I've settled into the routine of acceptance and the motivation to move forward.  I was once told by a former coach that it takes your body 3 weeks (21 days) to establish and accept a routine.  I've always thought of this when embarking on a new exercise routine (like when I started working out in the mornings - and I am not a morning person) but it seems to translate to any aspect in life. It is true that somewhere between day 14 and 24 of recovery the boot, the crutches, and the detour to normal life shifted to the norm.

When things were really rough (read: lots of crying) I decided to set three goals / rules for myself to target and focus my mind during recovery:

1) It's okay to cry.  It's fine to let it out and feel helpless and overwhelmed.  It's NOT okay to dwell in the tears, the helplessness, or the overwhelming activities.  Once a good cry has done it's work, make sure to dry those tears and keep moving forward.

2) Set goals.  Sure, the doctor-prescribed protocol has goals to work toward (like no crutches), but I need to set personal goals with short term rewards. I decided my goals don't need to be all about my foot - they just need to be "bite sized" and achievable.
 
During the second week (day 17) my goal was to make it to the beach, and watch friends play volleyball.  I did! This past weekend, friends came over to make fish tacos.  My goal was to learn how to make the perfect fresh margarita. In case you're curious, this recipe is potent and delicious. My current goal is to learn how to do polka dot nails.

Foot at beach!

Perfect margarita

3) Take all the help you can get.  I've struggled to ever accept help from anyone on anything.  It's just my personality.  But when everything I do takes 3 times the effort it normally does, it's worth accepting a neighbor's offer to check my mail, or asking friends to visit - then take out my trash.  If others are openly willing to sharing a little of my burden, I'm learning to graciously accept.

It's all about Perspective

As an oversubscriber to the cult of "Doing", I wasn't dealing well with my inactivity, and a future summer of fun that had in an instant turned bleak.  My weeknights and weekends are always non-stop.  In fact, I'm probably always on the brink of exhaustion because I try to fill every day to the limit.  For a snapshot:
Monday: AM row / PM home
Tuesday: AM SpeedX gym / PM yoga
Wednesday: AM row / PM home
Thursday: AM sleep in til 8! / PM Kickball then drinks
Friday: AM SpeedX gym / PM out
Saturday: AM row / all day beach volleyball
Sunday: football, any other outdoor activity  

During my first few days on the couch (just after the accident and before surgery) I was already struggling with how I was going to survive the months ahead.  Turning from tv to computer screen and back again, I couldn't conceive of another hour of idle time, alone on my couch.  Then I stumbled on this little Pinterest pin which did wonders to reshape my perspective. 

This is a detour.  That's all this is.  The world is not ending, I'm not out of sports for good, and it's only one summer that's going to be affected.  This one little quote reframed my mindset away from "end of the world" to I'm fortunate to only have a detour to travel along.

This quote and perspective helped me define and establish my "rules for recovery" which I'll get to in a later post.   It might sound silly to apply a framework to healing and idle time, but I've found it super useful when little things become overwhelming.

I'm also finding ways to "Do" while "Not Doing".  For instance, I've never been good at painting my own nails.  But now, I've figured out how to push chairs out on my balcony, get some fresh air, and paint away with no worry of running out of time for the nails to dry.  It's also been way too long since I read books consistently.  I didn't realize how much I've missed the  stimulation of a good book (and I'm taking recommendations!).

While I'm on indefinite pause from all the activities I love and identify with, I'm finding ways to explore new interests, and enjoy the downtime that I've been given.

14 Days in: Highs and Lows

To call this week draining would be and understatement. On Monday, I returned to work, trying for the first time to "quickly" shower and get out the door.  By the time I was ready to leave, I was already sweating in my business attire, and I still had to make it down 6 stairs and outside.

Since my car is manual shift, I have been using Uber to get around.  It is a GREAT service.  Cars are ordered and paid for all through an iPhone app, which displays a map clearly showing how far a car is away from you.  Plus, they are essentially Black Cars that are not currently in-use, creating a premium experience for a mainstream cost.  Totally worth the mini splurge when everything else I'm doing is a battle.

That said, by Tuesday morning I was ready for a sliver of independence.  With a week of work, doctor's appointments, and physical therapy ahead of me I decided to pick up a rental car.  The excitement of being behind the wheel again was worth a picture and a mini celebration.

So excited for independence!

Choosing a scenic route home for sunset

On Wednesday,  I had my first big doctor check-in.  If all looked good, the splint and stitches were due to come out.  Next step being a boot and the ability to start putting my foot down (with crutch support).  The appointment went amazingly!  The nurse stated the wound looked excellent - and it didn't have any of the normal scabbing or other nuisances that can occur. I was approved to move forward to the next stage - physical therapy!  I was shocked to see how alien my leg had become - turns out muscle atrophies incredibly fast - but the news of all else progressing as it should left me on top of the world - hence the highs of the week!

Shrunken left leg

Mini Scar & Swelling

I had my first session of PT on Thursday.  We spent an hour bending my ankle about 10-15 degrees up / down / side to side, trying to get it used to a neutral position.  It was so painful.  I could feel stiffness extending up the achilles into the calf.  My therapist reminded me at least 3 times I was in it for the long haul, and the first couple of weeks would be nothing more than just trying to bend my ankle.  

My comprehension of the serious of this injury comes in waves.  I keep it at bay by focusing on mini goals and little achievements to stay focused forward.  But nothing serves as a better reality check than trying to move and ankle and a foot that suddenly feels so alien, and separate from the rest of my body.  It's hard for my to comprehend that less than a month ago I was running and jumping off of it, and now I can barely move it two inches.

I came home from the early morning session both mentally and physically drained.  I had not slept well in the boot, and was worn out from the emotional toll of the first PT session.  I tripped twice getting ready for work, and the joy of actually being able to wash and shave my leg (after two weeks in a heavily wrapped splint) was outdone by the struggles of showering with the unprotected leg.

I headed to the office, amazed at how quickly I had swung from the high of Wednesday to the low of Thursday.  Once I got to work, all I could think of was a coffee to help perk me up - but with crutches I can't exactly carry Coffee Bean back to my desk.  When the clock struck 6, I needed to find a way to clear my head and get ready to start for a new day.  As I drove home, what had been a rare gray, drizzly SoCal day began to give way to sun.  I found an easy parking spot on the beach overlook, and let myself take in the view and also shed some public tears.  Oh what a good view can do.  By the time I got home at 8,  I couldn't fathom anything other than crawling into bed, ready to officially put this day to rest.

Head Clearing Pacific

Week One: Surgery!

Headed to bed on Wednesday night with my last meal and sip of water before midnight.  Surgery was scheduled for 1:30pm (with a 12:15pm arrival) the next day.  Was afraid I'd be parched by the time it came around!

I woke up at 9 the next morning to quite a few missed calls.  Turns out my time had been changed, but nobody had actually let me know.  In fact, I was supposed to be "under the knife" at 9:15!  They asked "when's the soonest you can get here?"  Luckily I live just down the street, so I took a shower (had a feeling I wouldn't be motivated to do so for another 2 days) and headed off to surgery.

The best part of this mix up was I had no time to stress, or anticipate the surgery.  The nurses took me to get changed, and then I had a brief meeting with my doctor and the anesthesiologist.  As we wheeled down the hall into the OR, I started feeling really strange.  A little woozy, hot but not too hot, a little cold...just strange. I mentioned it and the nurse joked, "that's because you're getting a cocktail!"  

I think they do this to calm you down before you go completely out.  I mean, it's pretty stressful right before you go into the room.  An IV is put in your hand, and the anesthesiologist then needs to explain to you how that since you are out cold, on muscle relaxers, lying on your stomach, someone else needs to do the breathing for you during surgery.  Luckily you're out cold for the whole tube-down-throat process, and the only after effect is a scratchy throat for about a day after.  For me, I was told they were about to put me under, and then the next thing I knew I was waking up looking out a window.

I entered the hospital at about 10:15, and went into the surgery I think around 11:30.  My brother and I were walking (crutching) out around 2 or 2:30.  Pain was non-existent since the doctor had done a nerveblock - essentially cutting off all feeling to my lower leg.  This has some risks, but the benefit is it staves off the true pain from surgery for anywhere from 12-24 hours.  For me, it lasted a full 24 hours, which was glorious!  

My brother and I took one last "jailbreak" from the couch for lunch before the pain hit the day after surgery.  That afternoon, the nerveblock wore off and the pain was, for a brief period, pretty unbearable.  I slept through a bit of it, but looked awfully pale and was extremely shakey.  I upped the vicodin to 2 every 5 hours during this period.  At night, I had serious trouble sleeping.  We actually stayed up late (like 1 or 2am) playing video games.  You may be thinking, "you should have been in bed!"  but when in pain, feeling wide awake, there is nothing worse than tossing and turning - especially when every turn is discomfort.  So, I went to bed when I was completely exhausted, and managed to fall asleep for a little bit.

Week One: Get to the other side of recovery

After a healthy dose of self medication via a wine bottle and a friend on Sunday night, it was time to get to the business of finding a doctor and understanding insurance.

I'm fortunate enough to row with someone who works in an orthopedics office.  She was able to help me get in to see a foot and ankle specialist on Monday.  Insurance - I was not so fortunate.  At first it looked like I would not be covered for this doctor.  Then it looked like the doctor was okay, but her affiliated hospital was not.  Then it looked like it was all okay - then none of it was.  Let's just say it's confusing, and it was hard to get clear answers.

I went to my appointment anyway, and the office took my card and did all the checking for me.  Told me not to worry about it.  In a day that had been filled with random crying outbursts (like on the phone with insurance when they told me the hospital was definitely not covered) it was incredible to be told, "Don't worry, we will make it work."

My appointment was fairly straightforward.  I had not done enough research at that point to ask how the doctor tended to perform this surgery (there are two options, both with their own pros and cons).  She did spend a lot of time walking through the recovery procedure.  This differed from my research, as her protocol puts me "walking" (in a boot, using crutches when I can't tolerate regular watching) about 4 weeks post surgery.  I had heard and read that it can be up to 8 weeks until you can even put your foot down.  This office believes it is better to reintroduce motion to the foot sooner rather than later.

She then said, in this late afternoon Monday appointment, "I'm thinking Thursday for surgery".  That's when it all hit.  Thursday is...this week!  It's soon! I've never had surgery before, and the act of agreeing to a date made what had been a surreal 24 hours suddenly feel very real.  She also reached out to my primary care doctor to coordinate a pre-op appointment and another appointment to make sure all the right precautions were being taken based on my personal medical history.

That night I began giving myself a prescription blood thinner injection (based on a pre-existing medical risk). Uh, I've never done THAT before.  When I picked up the prescription, the pharmacist described the needle as feeling like "a tiny prick" which you stick into the lovehandle part of your tummy.  I pictured the teeny tiny needle used to sometimes draw blood out of your finger tip.  In reality, it was much bigger.  Not the Biggest Needle Ever, but not one you necessarily want to be in control of having to stick into yourself at first once, and then later twice a day.  

But it's truly incredible of what you are capable of doing, when you really have no alternative.  I had to give myself a shot, so I just did it.  I had to figure out how to navigate my apartment (cook, eat, shower) on crutches, and I did.   Not always without help, and not without the occasional tearful breakdown, but it's to be expected.

The word "can't" is not allowed in my head.

It changed with a pop

On June 23rd, at about 2:40pm, I fully ruptured my left Achilles. It happened in the second half of a rec touch football league game.  Ironically, I had been thinking how fit I was feeling during the game - I was 2 for 2 on pass completions, and the girl guarding me had actually said I was too fast.

So I lined up, ready to sprint downfield to be open for a long pass.  As the quarterback called "hike", I pushed down on my back leg, ready to explode into a sprint.  I fell onto my hands and knees, trying to make sense of the loud pop noise I had heard.  Had one of the nodes on my cleats fallen off? Why did my foot feel so weird? Why was my calf tightening?  I reached back and felt the space where the tendon, which stretches from your calf to your heal, should be, tense and protuding just behind the ankle.  As I felt the emptiness, I looked up at the ref and told him, "there's been a pop, I think it's my achilles".  He responded, "Do you need an ambulance?"  Immediately I said yes.  

I've played sports all my life, at a competitive level.  As a kid, I spent summers playing tennis at the local club, and traveling to USTA tournaments all throughout New England.  In college, I rowed on the Crew team, and had the honor of being part of an NCAA winning crew.  Since then (and I'll be honest, it's been a few years) I've maintained my love of sport and competition.  I now live on the beach in LA, which is an outdoor activity playground.  My current sporting activities are rowing (3 times a week) kickball (once a week - though it is more social), tennis (once a month), beach volleyball (all day on the weekends), occasional yoga and any other sport I can get myself into.  So, while I'm not exactly elite like Kobe Bryant, I think it's fair to argue that I am more than just a weekend warrior.  And I know when an injury is going to require more than just and ice pack.

Pimp my ride

All the photos kept me smiling!

So as the ambulance was called for, I did my best to think clearly and get organized.  This was my second game with this team, and the friends I'd joined with were out of town for the weekend.  So I'd known everyone for a max of one week, and a minimum of roughly 40 minutes.  I tried to ignore the shock and worry on everyone's faces, and sent people off to collect my bag, fetch my wallet from my car (going to need that insurance!) and ended up handing my keys to newfound friends to deliver my car back to my apartment.  I knew my calm wasn't going to last long, so I capitalized as much as I could.  And then my chariots showed up - with a little too much fanfare.  A fire truck AND an ambulance? Feels a little excessive!  And speaking of insurance, do I need to pay for both?  I was whisked to the ER where, fortunately, the wait was short and the diagnosis was quick.  My foot was wrapped and suddenly crutches were placed in my hands.  The nurse worried that I looked "shakey" while trying to use them, but when you're still crying from learning you're going to need surgery and months of recovery, it's ok to shake.

While it's been just over two weeks since the injury, I've decided that writing and airing "my story" will help me process as I move down this little detour in life.  Even if nobody reads it. And I'm okay with that. :)