My compartments are (/were) syndromed

I feel bad I keep disappearing, but I have valid excuses…I swear! If you remember, a while back I complained about the uselessness of my legs. It turns out this was due to something called compartment syndrome. If you want to gross yourself out, look up pictures of compartment syndrome…better yet, I’ll provide some here:

Post surgery (May 4):

Foot bruising:

Stitches:

Bandages:

New small ace wrap:

Ice wraps:

After stitches came out (May 18):

If you can’t tell, I had surgery! In both legs!

For those of you who don’t know what compartment syndrome is (which is probably almost everyone – exertional/chronic/exercise induced compartment syndrome is pretty rare) I’ll give a brief overview. You have 4 compartments in your lower legs. Each compartment consists of muscle surrounded by a membrane called a fascia. In my body the muscles and fascia refuse to cooperate. When I run, or ski, or do anything that I would find to be at all fun, my legs feel like they’re going to explode with pressure, they have knives inserted into them, and they’re being squeezed by a vise.

Either the fascia isn’t playing nice and expanding to allow the muscles extra room when they’re expanding from physical activity, the muscles are being assholes and expanding too much, or both.

This causes the pressure to increase too much in the compartment which can be harmful for both the muscles and nerves. In my case I would get numbness in my legs and feet and have difficulty lifting my toes which would add a level of excitement to my runs – trying not to trip over my feet.

I’ve known about this issue for 9 months. I actually found out last August after returning from a surf trip in San Diego. I had scheduled the test before the trip, but wanted to hold off until I returned because of what it involved. The test is completed by shoving a meat thermometer sized needle in 2 areas of each lower leg. Knowing this, I decided to preserve the integrity of my legs for surfing…and to add a level of nervous anticipation to my vacation. Who doesn’t love ending a vacation with an invasive medical procedure?

When I went in for the test I hadn’t eaten yet that day, which was apparently a bad call. I got the anesthetic injections, which felt like fire being shoved into my legs, and then came the dizziness.

I’m always the person that who can’t take my eyes off the medical procedure being performed on me – leaning over the needle or meticulously watching each stitch being sewn in. So, it came as quite a surprise when the mere injection of some anesthetic and sight of a giant needle and pressure gauge resulted in tunnel vision. I informed my sports medicine doctor that I felt like I was on the verge of passing out and she asked me if I had eaten. When I told her no, she looked at me like a disappointed parent and asked her assistant to bring me a Power bar. I didn’t know I needed food in my belly! I rarely eat breakfast. I lied back on the table and ate my Power bar as she skewered my lower legs in 4 spots.

I twitched as I could feet twinges of pain with some of the stabs. All pressure readings were higher than they should be! Then it was time for my run. She covered the open wounds with band-aids and cleaned up the blood that had run down my legs and stained my socks. I ran around the block for about 15 – 20 minutes and returned, running in the place in the building (as instructed). Then came the second round of needle jabs. She inserted the needles into the open wounds and read the pressure levels again. This time the readings were even higher. I was diagnosed with compartment syndrome in all 4 compartments of both of my lower legs! The next week I hobbled around, feeling like someone had taken a bat to both of my legs.

From there I met with a surgeon who suggested that I attempt non-surgical methods to improve the condition before undergoing an operation. I had already gone through a a gait analysis and bought orthotic shoe inserts. My sports medicine doctor had attempted these fixes prior to the diagnosis of compartment syndrome. My surgeon decided I should try something called active release therapy prior to going the surgical route. I had to go to a chiropractor for a few months and have him wail on my legs. The bruising was an added bonus. I also tried a run/walk program to try to ease back into running (which I had also previously tried with my sports medicine doctor). Like all other attempts to remedy this issue, these techniques had no impact.

It seemed the only solution was surgery. So I met with the surgeon again and set up the surgery for January – a week after I’d be returning from my winter ski trip. Again, nervous anticipation is the key to any stress free vacation. But, for Christmas I got a new pair of skis! And because the snow conditions were less than perfect this last year I wasn’t going to be able to use them. My new skis were powder skis – Armada VJJs – and there wasn’t much powder, in fact there were rocks poking through the snow.

I decided that I was going to have to postpone the surgery so I could go on a spring ski trip (the recovery time for the surgery is 3 – 4 months, and spring skiing would be 3 months out at the latest). I was also a little uneasy about the implications of not being able to leave my apartment for a few weeks.

I cancelled the surgery while on my ski trip and decided I’d revisit this issue when it was no longer avoidable. I started to get some pain in my legs while walking over the next few months, which was a new development. Typically in the past the pain was present only during running or for a few hours – days after running.

A few months later, in April, I returned to Big Sky for my spring ski trip and it became clear that this was no longer avoidable. I wasn’t able to make more than 30 seconds at times without having to lay down on the slope because of the intense pain and pressure in my shins. I probably looked like I was dead to onlookers, but sitting was even out of the question. I needed my legs to be perfectly straight with absolutely no weight on them.

I knew during this trip, that I was going to have to have surgery before I could go skiing again.

The day after I returned from my ski trip, I called my surgeon and scheduled an appointment to see him his first available time a few weeks out. I asked all my questions and decided I was going to move forward with the fasciotomy (or as my brother calls it, a “compartment amputation”). We decided the best approach would be to address the 2 front compartments on each leg. These were the ones that were causing the most trouble, and he suggested that the rear compartments could be seeing some issues just because of the level of problems with the front ones. A fasciotomy on the rear 2 compartments leaves a much larger scar and requires a longer recovery time, so I agreed this sounded best.

The next hurdle was scheduling a surgery date. I apparently would need someone with me 24/7 for the first week post surgery. My parents were happy to come out and stay with me, but the problem was that their hotel was about to open and they would be occupied for the entire summer. Postponing my surgery until after they closed up for the year would mean I’d have to continue to deal with the issues in my legs for months, and I’d miss out on skiing in the 2012 – 2013 season. My parents told my that my mom could come stay with me for a week…2 weeks out. That was the only time that would work, after that their hands were tied. I called my surgeon and inquired about his availability at that time. I wasn’t holding out too much hope, but to my surprise he was able to fit me in on May 4th!

So, my brother took me in for surgery. The surgeon made a few incisions in each of my shins, found the nerve that gives sensations to my foot and moved that aside, and cut open the fascias for the front 2 compartments from knee to ankle.

My brother spent the night on an air mattress in my living room. The next day my mom flew in and spent the week cooking for me and keeping me company. When she left I was on my own, trapped in my apartment for another week or so with very little human interaction. Just as I was sure I was becoming some kind of Gollum-like recluse, I got the go-ahead to start driving. I’m able to crutch around and drive my car some…which is probably horrifying for anyone watching. I know they’re thinking: “She can’t walk, but she can drive?!” And the answer is yes, yes I can.

I’m still trying to keep swelling at bay. So I’m icing and elevating as much as I can – I’m pretty much a pro.