Running broken

Once again I've looked back at my blog and realised how long it's been since I updated things. The blog is proving to be really useful to me these days, as I'm back running, but the frustration of how much fitness and endurance I've lost can be overwhelming, so it's really useful to look back and see how far I've come.

Yes, I'm running again. And I have been since the 2nd of June. That was the date of my 3 month follow-up with my consultant. That day I had an x-ray, and, feeling very nervous (I'd been spending a lot of time in the gym and the niggling thought of 'what if I've damaged the fixation' was always at the back of my mind) I asked him if my knee was up to running yet. He pulled a face and told me not to do anything stupid (yeah, as if!!). Later that evening I ran 0.5 of a mile, lurching to one side like a drunk as my right leg had minimal proprioception or strength. It felt so good. Within a week I was back up to one mile. It's painful, always painful, but the pain would never get any worse during a run. Night time was a different matter, and my sleep was now constantly disturbed by a feeling I can only liken to toothache in the knee. Now, 2 months on and that is still the case. I'm hoping that this is partly to do with the metalwork, and that the pain will ease off a lot when this is taken out.

Now I'm back up to running most days, and so far I've managed a max of 18 miles. The thing I'm struggling most with is how SLOW I've become! I used to breeze along at 8 minute mile pace comfortably for a good 20 mile run. That is now a sprint pace that I can maintain for around half a mile before my legs just give up. And hills, I used to sail up a nice hill! Now I can just about plod to the top before I have to stop and let the feeling come back into my legs. And the weird thing is, it's my good leg that gives up first! I went running with Jason and he noticed that my gait was still slightly uneven. I can only assume that this is putting extra stress on my left knee and quad. Anyway, it's intensely frustrating, and for the time being I've given up running with any form of timekeeping or GPS due to the despair I feel when I check my time and find out how slow it is. I work hard, I feel out of breath, my lungs burning and sick to my stomach, and I'm just about hitting a 7mph pace, and for a second I'm disgusted with my body.

It's been hard watching other people I know do races and achieve such amazing things. I've watched races go by, seen course record get broken, seen friends selected to the GB team. Meanwhile I can just about manage my old routes without stopping every mile to rest.

So, I read my blog the other night. And I counted back and realised that it's only been 5 months since my second op and only 3 months since my brace came off. 3 months!!!! I remember the despair, the feeling of loss, the terrifying unknown before me when I lay in ED and they told me just how smashed up my knee was. And now, I'm out running EVERY DAY! I don't think I could have anticipated this back then, and I feel incredibly lucky that everything is actually going so well! When it first happened, I read about the severity of my injury, the biomechanics, the healing process and long term functional limitations and I was prepared to never be able to run properly again. I know that what I should be doing is counting my blessings every single second.

So, here I am, counting my blessings.
If you're reading this, then you're probably one of them.

Dear diary

As I sit here, 3kg ankle weight on my leg, straight-leg raising and munching on a protein bar, I can't believe it's been so long since I last wrote a post.
So much has happened. I'm now walking, brace-free and slowly regaining muscle in my quad. I'm able to swim again and I have the flexion to manage the bike. I've spent more time on the elliptical trainer in the past 4 weeks than I ever wished to experience.

So, as I've been so remiss in posting updates about my experience, here is a brief diary.

14th of April. 6 week follow-up. Consultant said I could start fully weight bearing. I punched the air in excitement and nearly told him that I loved him...embarrassing considering that I used to work for the orthopaedic department. I went for a walk around the hospital. Just because I could. I spent the rest of the day with mum, walking around with both crutches, occasionally reducing down to one crutch whilst shouting 'mum, mum look at me!!' Must of been like having a toddler again for her! When I got home, I made cup after cup of tea and carried them around the house, just because I could.

15th of April. Went to the gym with both legs working. Got on the elliptical trainer. Got off again. Got back on again. Got off again. Finally got on and did 5 minutes. It felt weird and naughty. Stuck to the rowing machine for the rest of the week.

17th of April. Went for a WALK on the COASTPATH with my dad. Still using both crutches, but I felt like I was free.

18th of April. Got Jase to drop me off 2 miles before work and walked the rest of the way in.

17th April. Went for a proper off-road walk around one of my shorter running routes. Cried a lot.

22-24th of April. Did my first full weekend on call. I can't describe how wonderful it felt to be doing clinical work again. I love my job.

25th of April. My brace developed a squeak. I don't think they're designed to do quite as much as I'd been doing with it. It was due to be off completetly on the 28th, so I decided to ditch it a couple of days early. I was finally BRACE FREE!! Had my first physio appointment, he gave me a load of exercises to help develop my quad. It wasn't until this appointment that I realised how little function I had in this leg. I could balance on it for about 5 seconds, but it was like I was standing on a wobble-board I was so unsteady.

26th of April. Got back in the pool. Swimming was fairly alright really, as I don't use my legs a lot anyway. Managed 1km without too much of a problem.

28th of April. Went for my first walk without a brace. Decided (probably stupidly) to leave my crutches at home and only use walking poles. And to wear a 10kg weighted pack. 7 miles later and I thought my leg was going to drop off.

30th of April. This was the weekend that I should have been up in Scotland running the Hoka Highland Fling for the GB trail team selection. It was also the weekend of the TP100, and someone running it beat my previous centurion 100 record of 16hrs 13 minutes with a new record of 16 hours. I spent a lot of this weekend in tears.

7th of May. Went for a row out in the gig followed by a swim in the sea. All the while, all I could do was stare at the coastpath and wish that I was running it.

11th of May. Went out on my mountain bike for the first time. It felt great to be outside, but I hurt a lot afterwards. Realised how much further I had to go with this rehab lark.

It's been an emotional rollercoaster, punctuated with highs as I progress on to new things and lows as I inevitably do too much and my knee starts to hurt like hell. When I get pain, I start to despair and feel like I'll never run again. Sometimes I end up in a panic that I've caused further damage. I have a whole host of caring friends and family telling me to take it easy. If only it was that simple. I'm still having to make use of my designated sad time to help me deal with this.

So, onwards. For now I'm mainly focusing on trying to regain muscle and function. I'm back to swimming a lot as it's the only exercise I can really throw myself into without the fear of damage.

It's a long long road.

Big gym

It's been a busy week, which is brilliant, makes time pass so much faster! I'm now 3 weeks from my second operation with only 3 weeks to go until (hopefully) I can start rehab!!

Monday, I went back to work, for the second time. I was so happy to be back again, I was really worried that after my re-fracture they wouldn't let me back on crutches. It felt great to be back again (again!). Friendly faces, hugs from friends and colleagues, feeling like I had purpose. Moving around in the hospital still fills me with a lot of anxiety, and so I'm lucky to be allowed to stay in one place doing discharge paperwork.

Tuesday was my birthday. I had been a bit worried about this, as every year since I turned 30 I've done a race to mark my birthday. I was prepared to feel quite sad this year. However, I had promised myself that I would enjoy the day the best I could, and try not to worry! This started with me having chocolate cake in bed at 5:30am. I've been trying to go easy on cake since this accident happened. For the past few years I've taken for granted the fact that my daily calorie expenditure is such that I can eat anything I like. Without this to fall back on I've been far stricter with my diet. But, it was my birthday, so I was going to eat whatever the hell I wanted with no guilt. And I did, I really did!! The day finished with a meal at 15 with Jason and my Mum and Dad. It was wonderful! If I'm honest, I think I probably enjoyed all the food even more than usual because it was such a treat now that I'm being more careful of what I eat!

And, to top off a fantastic birthday week, on Thursday morning at 6:30am (which was our normal routine) Jason took me to the gym. I cannot express my excitement. I've been regularly going to the gym in the morning before work for the past 4 years, so I know a lot of the other regulars. Jason had told a lot of them about my accident, so I didn't have to go through the story again and again, I just got loads of good wishes and people saying how amazing it was that I was going to the gym on one leg which made me feel really good about myself. I heard a really encouraging story from one guy there who was once told after a back injury that he would never run again and has since run a 2:40 marathon. All these little bits of positivity help me stay focused on recovery and make me realise that a lot of this will be about what I make of it. I know my patella is rogered. I know the articular surface is messed up and that I'll get problems with arthritis. I know that there were a few bits of it that were so smashed that they had to be removed or just left with no fixation because they were too small to fix. But I also know that every race I've run in the past year, I've run with screaming pain in my back and right hamstring, pain which I have just learned to put up with. If I can put up with that, then I can also put up with whatever pain I'm left with when this knee is healed. For me, pain is part of endurance running, and something to expect and deal with mentally.

In the gym I put one-legged erging to the test. The trick is to have a towel under your bad foot which lets it slide along the floor with no resistance. Then you can just ignore this leg, letting it slide back and forward whilst you row with your good leg, arms and torso. I  imagine it's probably the most 'whole-body' workout that you can get whilst on one leg. I can manage this for about 30 minutes before my left leg starts to really cramp up from the intense work and unaccustomed position.  After this I spent some time playing with the hand cycle in the gym which is a really massive version of my one at home, and gives a really good high intensity workout.
I could have stayed in the gym playing on stuff all day, I finally felt like I was at least a fraction of the athlete I was before this happened. I went back on the Friday for more!

So, now I know what's possible, I'll see you down the gym!

Angels without wings.

2016 has not been a good year for me so far. I'm hoping that I've paid my dues to whatever aspect of fate I owe, my run of bad luck is over and I can just get on with my life now. I suppose none of us knows what fate has in store for us. Despite that fact that I participate in relatively extreme sports I never saw myself sustaining an injury that would have such an impact on my life.

On the other hand, I am very lucky. Last week in Plymouth a cyclist the same age as me was killed by a dangerous driver. I know from the state of my bike, cycle helmet and patella that if I had landed differently I could have sustained far more serious injuries. My head smashed the drivers windscreen as I went over her bonnet and I escaped with whiplash alone, not even a concussion. Jason frequently reminds me how different that call he received from the police could have been...

Counting my blessings helps me through the difficult periods, the days that I cry and cry and just long to put on my trainers and run out of the front door. If I can just bear this period of recovery, then I will be able to get back to my normal life. Even if that no longer includes competitive running, there is so much that I can do. Had I landed differently during the accident then I might not have had that option.

But counting my blessings  alone is not what is getting me through this. It's you. Whoever you are, reading this, giving me positive input no matter how small.

I am truly lucky to be surrounded by such wonderful people. From the moment that this injury occurred I have had people beside me, supporting me, holding me up when I'm down. My wonderful parents; Dad who has put up with my constant questioning about whether he thinks the bone is healing properly, Mum who has looked after me as if I was 10 again, driving me to appointments and caring for me like only a mother could. My ever-patient husband who has dealt with my frequent and dramatic mood swings, my fears and my pain.

And my amazing circle of friends, constantly giving me encouragement, wishing me well, offering to help me out wherever they can.  I have received such amazing quantities of love over the past few weeks. I don't think I could ever express what you have done for me, and the words 'thank you' just seem so inadequate.

So, this blog post is by way of a 'thank you' card to each and every one of you. It's not enough, and no amount of thanks ever could be, but it'll have to do.

Flexion mark 2.

Thursday 17th March - 7 weeks post-accident, 2 weeks post re-fracture with 4 weeks on crutches NWB left to go (provided I don't balls it up again). My clips from my second operation came out, and my brace was set to 40 degrees. My poor knee. 7 weeks during which the greatest percentage of time has been fixed in extension. This joint has become fixed nearly solid. I've been desperate to flex the joint. I'm convinced that most of the pain I've been getting for the past week has been due to stiffness not the fracture. When the brace reset, I made it to 10 degrees, and stopped. The only thing I can compare the feeling to is trying to bend one of your fingers back into forced extension. It won't go, and it feels like it shouldn't. In the case of your finger, that's because it's not meant to. In the case of my knee, it's because scar tissue and swelling are causing the joint to fix. I've spent the past 24 hours easing it into flexion, and now make it to 30 degrees, but it feels painful and tight. In honesty, I've probably overdone it, but I'm feeling particularly impatient at the moment.

My mood swings are still quite intense, the days at home along are long and tedious. My underlying depression gives me significant diurnal mood variation, so mornings are my best times. I'm countering this by doing all my exercises in the afternoon to try to balance my mood as best I can. The next 3 weeks should be better, as Jason is on holiday and so I won't have long periods of time alone.

I've been trying to improve my static exercise routine. I've been using the hand bike for at least 30 minutes each day, spending at least 15 minutes doing core exercises, focusing particularly on my right leg gluts and hamstring as well as my abs. I'm also able to get back on my turbo trainer now I've got some movement in the knee. I'm managing to maintain my weight pretty well. I've lost 2kg, which I attribute to the loss of muscle from my right leg, but my general shape is staying pretty static apart from an increase in the size of my arms and shoulders.

So, a bit more about static exercising.
Hand bike. I thoroughly recommend this to anyone who is immobilised for any period of time. You can get a whole range of styles. Mine cost around £50 from Amazon and has a basic resistance dial and a LCD screen which scrolls through time, rotations, distance in KM and calories. It sits comfortably on my kitchen table, and is easy to put away afterwards. The highest resistance setting isn't that taxing, but by varying resistance and RPM for periods of time you can get something akin to a spin session. You can also vary your arm and body movements as you 'pedal' so you can work your torso quite well (it's an action similar to hoola-hooping!)

I can't recommend this gadget highly enough, it makes it possible to get an aerobic work-out whilst sitting down.

Positives:
Working out a way to use my exercise regimes to balance my mood swings.
Managing to get from 10 to 40 degrees of flexion over 24 hours though a combination of gradual work and regular icing.
Finally having a shower! (now my surgical clips are out, I can sit in the bath with my brace off and shower. It felt AMAZING!)

Plodding.

It's been 12 days since my second operation. 12. Long. Days.

I'm struggling mentally to cope with the immobility this time round. Every day stretches out to eternity and I find it hard to deal with the time laid out in front of me until I can get back on 2 feet. I feel like I'm in a terrible never-ending limbo of misery and despair and I have spent an awful lot of time in tears (I'm actually crying as I write this). I've also started to suffer from real anxiety around mobilising, out of fear of falling again. I find it hard to be in public places for a similar reason, just in case someone bumps into me. And every time I get a twinge in my knee I become paranoid that the bone is becoming avascular and the healing process is failing. My GP has increased my antidepressant medication and added in a second agent to help me get through this period. I'm not sure that it's having any effect.

In short, I'm a bit of a mess.

So I've mostly been at home. I did venture out last Saturday, under the comforting and watchful eye of my wonderful mother. We went singing for the day, and it was wonderful to be doing something different. East Cornwall Bach choir put on a 'come and sing' day. We met at 10am, spent the day rehearsing Mozart's Requiem, and then sang the full work in the evening. By the end of the day I was exhausted, but it gave me a lift to have been doing something, focusing and then performing. I'd forgotten how much singing means to me.

I'm slowly getting back to my pre-fall static training. Initially I just started on my hand bike. That was about 7 days postop. The first time I did 20 minutes, I slept for 3 hours afterwards. It's amazing the demands healing makes on your body! The handbike helps me to work up a bit of a sweat, and I can now do 40 minutes straight (time mainly limited by the need to move my leg after this long). I can't manage to get onto my turbo trainer yet (my leg is still fixed in extension), but I'm now able to get onto the floor again, and so can do a range of core exercises. I've also been trying to focus on my right leg gluts, abductors and hamstrings, because I'm going to need some serious support from whatever muscle groups are left in this leg after 11 weeks non-weigh-bearing.

I'm also focusing on trying to keep my diet healthy with each meal providing high protein and eating lots of raw veg for vitamin content.

So, I'm getting there, but by Gods it's slow. This Thursday my surgical clips come out. Then I face another month on crutches before I can start physio. Of course, there's always the chance that I'll have gone insane by then!

Positives:
Spending the day singing with my mum.
Persevering with the static exercises.

On a lighter note..

This morning the following items arrived at my bedside courtesy of Jason. He is 'optimising my nutritional intake to get me running again' (his exact words)!

Then a second item appeared. This is, apparently, 'all about the presentation which is everything, look, I've used some leaves off a coconut, or a pineapple, or some kind of exotic fruit anyway. It makes it look all posh.'

I am lucky on so many levels!