Monday, April 28, 2014

The Continuing Adventures of a Girl and her Dog

Trixie and I have done a LOT of walking...80 miles since I was cleared to walk on 4/9, and nearly 40 miles in the last week. Compare that to my average run mileage with my malfunctioning artery over the last year, which was maybe 15 miles a week. I have been so happy to simply move around outside and to explore sections of running paths and trails that, as a creature of habit, I do not normally go on. This week I made a point to do just that - explore!

 First time on the Coal Mining Heritage Loop off of the Huckleberry

Trixie did not like this bridge

She walks with the leash fully extended unless someone is coming, then she tucks in beside me.
She has really really good walking manners.

 The cow was more interested in Trixie than she was in the cow.

Huckleberry from the Price's Fork fire station out 1.4 miles to a dead-end that will
extend to Brown Farm sometime this fall.

Trail behind Foxridge, headed toward the new section of Huckleberry.

Another cow admirer.

Aside from some slight abdominal pulling sensations, I've been feeling really good. So, Saturday I headed out for my biggest walk of about 10 miles. I was chomping at the bit to walk the less-traveled trails of Pandapas Pond and it was a perfect, perfect day for it. When I pulled up to the parking area I saw folks doing some Search and Rescue training. I asked them if my reputation had preceded me and they were there ready to come and find me? Fortunately I did not need them!
Poverty Creek, Queen Anne, Skull Cap, Trillium, and Head Hunter. Cool trail names!

Water is plentiful along the trail for Trixie.

 Who needs stepping stones? We plow through the water...

 ...not everyone feels that way.
Equipment Coach Bryan came out for Sunday's walk and opted to keep dry shoes.

 Baby black snake?


The horse option looked like fun, but I still was glad to travel on my own two feet.


Wednesday I head back to see Dr. Davidson and find out what is next for me.

Tuesday, April 22, 2014

Walking moves to the mountains and trails

I've been really enjoying my prescribed recovery walking. Just like with training, I am making the time and scheduling it in, and truly appreciating it. Trixie has become my very faithful companion, particularly as we have moved from walking in town and on the paved Huckleberry Trail to walking the trails of Pandapas Pond and the Jefferson National Forest. It's so beautiful there as it offers up a variety of landscapes plus lots of places for Trixie to grab a drink and for both of us to splash in Poverty Creek.

Trixie, it turns out, is amazing on these walks. At intersections she has learned to understand "left" and "right" and she comes to my side whenever other people/dogs/mountain bikers approach. I am really glad for her company and great behavior.

My walks have become much hillier on the mountains to the point where I called the doctor's office yesterday to check if my allowable "walking" permitted trails and hills? Dr. Davidson's partner relayed that as long as I could tolerate it, it would actually be good for me. (I hope he knows who he is dealing with.) I've climbed about 5000 feet over the last three walks, and I've walked almost 50 miles since I was cleared to walk April 9. I am pretty sure I feel fine....but I sometimes doubt my ability to know.

With all that climbing, I've noticed zero problems with my quads or toes. It's such a treat to have blood and oxygen circulating freely in my left leg!! It's been nice to get my heart rate up on these sustained climbs, but without running or pounding to bother my abdominal healing -- to allow the "glue to set."

I've used this time to explore trails on the other side of the creek that I don't normally run. Which, given my famous lack of navigation and directional skills, prompted this text on Sunday:

Scenes from Trixie and I in the Jefferson National Forest:

This is what my bike looks like from disuse. Spiderwebs have begun to form. But you know what? I'm OK with it and have settled into this time having disembarked from the crazy train of intense training rand racing. I don't mind the mental let-up and slower pace.

My friend Liz Baugher recently sent me this piece by Kelly Williamson - "Positives from Setbacks".  In it, she shares her enjoyment of walking and positive approach to healing. Hopefully she doesn't think I'm some creepy stalker, but it's just really uncanny to read her reflections that so closely resemble mine. The last line is what really struck me, "Life would be pretty boring without any scars to show."

So while it's all good, I will admit I've started thinking about my race season from July forward and even made some hotel reservations for a few races (all cancel-able). But I'm still taking it one day at a time right now and being happy where I am. I go back to see Dr. Davidson in a week.

Thursday, April 17, 2014

You might be a competitive walker if...

  1. You wear your Garmin while walking.
  2. You stop your Garmin for all non-walking (stoplights, dog peeing, etc).
  3. You walk with your friend Gail, and she totally understands you can't possibly stop at 59 minutes when it's so close to one hour. (so she graciously suggests you both take a lap around the outside of the house.)
  4. You see you might just make 3.5 miles in an hour so you push for a good finishing kick (at a walk) and you get it.
  5. You see a 14 minute first mile and start calculating how far you might get in an hour.
  6. You get excited to hit a 4.3 miles-in-an-hour PR. (Feeling a little better each day!)

  7. Then you realize it was not a negative split. Ugh! New Goal! Negative split!
  8. You spot the fastest walker on the indoor track and get in "race mode" to catch her. It takes you three laps to do so then you thank her for setting the walking bar high. Conversation follows :) and it's so nice to get to know her.
  9. While chatting and walking, you are discretely using the Garmin to count laps knowing it's 9 to a mile.
  10. On the outdoor walking trail with the dog, you spot the pink-clad "dog walking" competition up ahead and get in "race mode" to catch them. Your dog is pulling you forward, and hers is pulling her backward. You chalk it up to clever race strategy!! (Yes, she pulled aside, conceding defeat. That, or she didn't know we were racing. Whatever!)

  11. You start thinking about how funny it would be to have "tempo" and "threshold" walk intervals then think maybe that is not such a crazy idea.
  12. You feel satisfaction having walked a marathon (26.2 miles) in 7 days, even though you remember back a year when you ran a marathon in Boston in 3:33. Goals and accomplishments are relative to where you are and 2+ weeks post surgery, you'll take it.
I prefer speed, but I choose happiness, fun, and a little healthy self-competition at any speed. This walking stuff is not all that bad, if you make a bit of a game out of it! The dog sure likes it!

Trixie on the Huckleberry Trail. What a good pup!!
Zero squirrel lunging and such a good listener!!

So how am I really feeling 16 days post-surgery? Better every day, but I see it will be a while before I am pain-free. I was allowed to remove all the steri-strips yesterday and the incisions themselves look good. Areas around the groin and abdomen incisions are still swollen and sore, but along with everything it's improving slowly. I can tell nerves were irritated/disturbed during surgery with some numb areas around the incisions and I'm semi-numb on my outer quad with some odd pulling sensations around the thigh incisions (adhesions?). I know it all needs time to settle down and work itself out.

The good news is I'm not noticing any of the symptoms I used to have. My energy is rebounding pretty well too; I think the narcolepsy and uncontrollable napping have passed!

In the meantime I will just keep moving and walking, per Dr. Davidson's instructions. I'm getting restless for a bit more, so that must be a good sign.

Where every you are in your training, whatever your speed, whatever your situation, make the most of it and enjoy it!!

Saturday, April 12, 2014

Profile of a Roadside Litterbug

This morning, I joined Curt and Sita to clean up the New River Valley Bicycle Association's stretch of "adopted" road on Den Hill Road. It was a beautiful spring morning and I was glad for a chance to do something useful for a section of road that I cycle often. When you walk a road you observe things you don't notice with the speed of a bike.

With a number of organized bike rides and the "3.2 for 32" run on campus, we were few in number, but no matter! Curt had it very well organized. I got the "Marshal" vest, so I took that to mean I was the one to boss people around. I asked where was my shotgun and prisoner van? I tried not to let so much power go to my head.

I think we ended up with 9 bags of trash across maybe a mile and a half or so.

Trash pickup became a fascinating anthropological study of the Roadside Litterbug. Here are some of the characteristics of this subgroup of the species that I noted:
  • They drink cheap beer - Busch, Miller, and Bud are among the most popular. They favor "light" beer. Guess they are concerned about maintaining racing weight and lean muscle mass.
  • They smoke Marlboros and empty their ashtrays around corners. That's probably because they like to keep a clean, tidy car!
  • Those who do not smoke, chew.
  • They buy lottery tickets but neglect to recycle the paper.
  • They like energy drinks! Must be hard workers!
  • They eat Happy Meals but don't save the toy...what's with that?
  • They enjoy fresh breath, as evidenced by a Duck Dynasty breath mint wrapper Curt discovered (ewww)
  • They drink quite a bit of coffee....and liquor. Perhaps they alternate between the two, like a super set, or interval training!
I really don't understand the littering mentality. It's very self-centered and short-sighted. How hard is it to find a garbage can, which are at every gas station and store!!

Things noticeably absent:
  • Gel packages or cyclist detritis
  • Craft beers
  • Organic snack wrappers
It was great to get out and do something different but I was pretty tired afterward. This is how it goes these days - do something, rest, do something, rest.

Final images that I found Googling about -- clever and fun!!!

Thursday, April 10, 2014

"As far and as fast as you want"

At my staple-removing appointment yesterday Dr. Davidson said that I can walk, as far and as fast as I want. No lifting, swimming, biking, or running. No skydiving, parkour, javelin throwing, or steer wrestling. And if my husband is reading this, I believe I also heard him say absolutely no grocery shopping...EVER again. He was very firm, so thanks for taking care of that :-)
I did ask, "is there an upper limit on this 'as FAR as I want?"

"Do you mean as in distance?"

"Yes," I replied, "like miles."

"No, no limit, just keep it to a walk, but it can be a fast walk."
Cool! However, I don't plan to set any walking records as I am still pretty tired. A morning of work, the hour drive to Roanoke, the two hours there, and an hour back, left me wiped out and in bed. But we've got beautiful spring weather and sunny skies and I look forward to being out in it...maybe even with the family if I can recruit them. If not, Trixie is always rested up and willing. She went with me this morning.

He also asked if I was noticing any symptoms walking up the stairs as I had before. I had not even thought about it. I guess not!! When I came home I walked up the steps at a good clip, and sure problem! No fatigue and none of that blood oxygen deprivation feeling in the quad that is hard to describe. It's amazing how quickly I had forgotten that, considering the stairs were a constant reminder for me.

I'm enjoying having warm, even sweaty, feet again.

It was my first time having staples, and so also the first time having staples removed. It was not a totally painless process to remove all 50, but it was not a big deal. I asked what was the most staples a person had had removed in that office and they said that some people had them up the full length of a leg, every 3 mm. OUCH!

I wanted this staple remover:

But I got this:

The incisions are now only taped with steri-strips (17, of course I counted). 

My upper ab incision area is still very swollen. I don't think I'll be in my jeans any time soon. This means my wardrobe has swung even further in the direction of workout clothes.

We talked about which of the ab muscles he had to separate, move, or split "with the grain" (my term) and which obliques he had to just cut across. That helped me understand the lingering pain I am having and at least replace this image I had of myself being "cleaved" through. I was only partially cleaved through. Hopefully a week from now the ab discomfort will be significantly improved.

I feel a lot better having been checked on and look forward to some good walks to come.

Tuesday, April 8, 2014

The slow return to "normal"

I'm one week out from "being on the losing end of a gentleman's knife fight" as I heard surgery described. I'm not really into knives, so I've chosen to illustrate that concept with a pick-ax and Minecraft world (nod to my kids and Photobooth).

It's been interesting to be a participant observer in this process.

My summary thus far: This bit of pain I can handle, no problem. Nausea, dizziness, fatigue, and general malaise...ughhh...that part has been a little harder.

The pain/discomfort since getting through that first night of belly bloat has been very manageable. I won't pretend it's been bad or even close to what others deal with on an ongoing basis.

Mainly I just have to work around sliced left obliques and some disturbances to the rectus abdominus. I need to be careful when I get up, but the whole right side is just fine and usable. Coughing, sneezing, laughing, or turning over in bed take a bit of pre-planning. But the incisions themselves aren't even that sensitive and at this point I don't think a whole lot about them.

When I move, I'm bent over and slow for the first few steps, there's some groaning and wincing now and again, and I have to be careful. It's a very small price to pay.

I have even found a few times to use my situation to my advantage. Last night I did say to the kids, "don't worry about your poor mom, held together with thread and staples, I'll bring it to you!!!" And I did enjoy showing my longest incision at the waistline to Grant's soccer team, by request.

Whatever discomfort I am experiencing, I am fortunate that it's productive, good-in-the-long-term discomfort. I have been WAY more stressed from other pains - the unknown, the more chronic, or the race-threatening pain.

The nausea and dizziness were more frustrating. I felt pretty good on Thursday when I left the hospital and then backslid on Friday at home and just did not feel good. I'm sure that was from the lingering effects of anesthesia, morphine, Lortab, red Jello, non fair-trade coffee, and other toxins still in my system. Dr. Davidson had encouraged me to move around a good bit so I got one walk in during the day and by the time I felt up to walking again, it was dark. So I hit the treadmill for a short (12 min), slow (2.5 mph), amble. I thought about how weird it was to be on the treadmill, 3-1/2 days out! (Then I thought, somebody should probably hide the safety key that prevents it from turning on.)

Saturday and Sunday mornings I woke up with a headache and had a very hard time dragging myself out of bed. But eventually I did, and I drove Grant to soccer games both days and enjoyed watching and walking around the field. The fresh air and company did my psyche a lot of good. I drove the boys to a sleepover Saturday, and folded a few loads of laundry. Aside from a lot of extra napping, life was getting back to normal.

Monday morning I woke up wanting coffee for the first time. That was a good sign! I worked a good bit of the day, and finally no dizziness or nausea or headache, just a little tired.

Fortunately, I'm on no prescription meds and even stopped the Tylenol. I'm taking my multivitamin, D3, a baby aspirin, and Arnica Montana for the bruising. I'm eating good foods (thanks April, Therese, and Gail!), staying hydrated, and resting.

Psychologically, if I let myself think about it, I can get weirded out by the idea of a 7" long patch on such important artery. It's amazing to think that can be done without leaking and sometimes I worry if anything I am doing is jeopardizing the healing -- some position, or movement. It somehow seems wrong to just be just sitting and walking normally with that going on inside. But I don't dwell.

All-in-all I have to say this has gone pretty smoothly. I keep perspective that it's a fix to a plumbing (vascular) problem, not something chronic or ongoing and I am extremely fortunate to have had the chance to have it corrected.

Check out the "expression" on this flower from Coach Jim and his family. This has been cracking me up!

Clearly I have more time on my hands these days to notice screaming flowers and make Minecraft green screen photos.

Tomorrow I get un-stapled and can check in with Dr. Davidson and see how his training is going for the Mountains of Misery century ride the end of May.

I hope your spring training is going well!

Friday, April 4, 2014

Surgery Report: My External Iliac Artery Repair

I am looking forward to this blog returning to a triathlon focus, but as a journal of the ups and downs of being an athlete in the sport, this surgery is a part of my story. If you'd rather avoid this detour, tune back in sometime in May. But I am sharing this in the hopes it will help someone else, just as Kelly Williamson's report helped me.

What a whirlwind the last few days have been. I showed up at Carilion Roanoke Memorial Hospital 6 am sharp on Tuesday and things immediately got underway for 7:30 surgery. As I was being prepped, I met with my vascular surgeon, Dr. Jesse T. Davidson, III (pictured above) and anesthesiologist Dr. David Thompson and also got a surprise visit from tri-pal Karen who is a third year med student working in the hospital. She walked in as we were discussing cycling and she said, "I figured!" It was here that I learned that my initial pressure testing done in late February showed my leg pressure dropped by half after running and took 20 minutes to recover. No wonder I had problems.

As I rolled down the hall Dr. Thompson gave me the first sedative that he referred to as a "glass of wine," to which I said something about "is this like a pub crawl?" and that's pretty much all I remember.

I woke up in recovery feeling nauseous and loopy but not in any real pain. I learned then that Dr. Davidson had patched 7" of scarred and narrowed artery and separated the inguinal ligament where it was pinching the artery. My husband asked Dr. Davidson about the chances of this problem recurring and he reportedly replied "not in that leg" which is very reassuring!

Then I was taken to a room in the Vascular Progressive Care Unit. Here is the requisite hospital bed shot. I had three bandages - one around my thigh, one diagonal lower abs, and one mid-ab. 


They put a cuff on my good leg that inflated on a regular basis to keep blood flow going and reduce the risk of blood clots for the first 24 hours I would be stuck in the bed. It was my knock-off NormaTec recovery boot. 

Then the fine dining began. I was on a liquid diet for nausea and it was just as well. I had little appetite.

Tuesday night was rough. I did not sleep much, but was in some state of morphine-induced twilight zone of random thoughts and images parading through my brain. My bloated stomach hurt and I could not get comfortable. By Wednesday that pain had subsided, replaced by a headache that was remedied by a cup of coffee. Caffeine withdrawal, I suppose!

By now I was feeling downright proud of my booming ankle pulses (x marks the spot!). My ankle had its 15 minutes of fame.  I was told that palpable ankle pulses were pretty unusual since they don't get too many healthy people through the unit. The staff and nurses uniformly sang the praises of Dr. Davidson. I have discovered over the last few months, from my friends in the medical community, that his reputation, skill, and expertise are extremely highly regarded. People rave about him, and I feel very fortunate that a series of events and people led me directly to him.

Wednesday morning a fellow named Brian showed up to take me for a walk. It turns out he had moved from the very town in Pennsylvania where I was born and his son is a cyclist who works for Cannondale. Small world! Obviously my ability to chit-chat had not been impaired. Once I got moving I felt OK and walked at a good clip, prompting the nurses to tease him about his ability to keep up.

Karen came by a few times to check on me, as did another tri-pal, Casey who works in IT for the hospital! Very cool! 

Karen and I at CRMH (above) and at PPD Beach2Battleship (below). I prefer the photo below!

The hubs came back Wednesday night with the kids. I have no pics because the kids were pretty weirded out by it all and I was busy offering reassurances and trying to keep it light. I took them for a walk around the floor and tried to show them all the cool stuff. Suffice it to say, medical careers are likely not in their futures.

Equipment Coach Bryan came by (arteries counting as "equipment") and helped by filling out the Discharge Planning board to be sure everyone knew I would be ready to leave Thursday.

Wednesday night went a lot better. I tried to go morphine-free but caved in, got a "hit" sometime in the night, and subsequently slept relatively well between interruptions. 

Thursday morning I got disconnected from the ECG leads (or whatever they are called) and the IV (of which I had two, one smaller, done pre-op and one larger, put in when I was asleep) which meant I could finally put normal clothes back on.

 So it was a triathlon shirt, of course - 2013 Nationals!

We also took the dressings off of my incisions. I was a little taken aback by what I saw, but I would adjust.

By now I was roaming the floors solo, as I was told that it was good to move around. At one point the phlebotomist was trying to find me to draw blood and couldn't locate me. I think that's a pretty good sign it's time to go home.

Before I went home I had some great conversations with the nursing staff about running and triathlon and I saw the gleam in the eyes of Natasha, Emily, and Karen! I see some good athletic goals in their futures! In all seriousness, the staff in the Vascular PCU was fantastic.

I arrived home at 3 pm on Thursday, just 57 hours after this all began. And if you are interested, here is the picture of my five incisions, 50 staples, and bloated belly. I think the four on my leg were from where the vein was harvested and the one across my abs was to access the external iliac artery which is tucked in behind the intestines. I put on a bikini suit bottom so it is a "G" rated photo. I will probably not be wearing this bikini bottom again. No biggie, I'm all about function over form!

Note I had Dr. Davidson's pre-surgical "autograph" on there, lol. Next Wednesday the staples come out.

Last night went pretty well. I woke up a few times but generally slept through the night. I took one of the pain meds overnight and woke up feeling nauseous and rough. I think I need to avoid those meds if at all possible.

This morning (Friday) I'm just laying low and trying to kick this round of nausea - hydrate, sleep, move around, repeat.

Thank you for the support and well-wishes along the way.