Tuesday, April 28, 2009

April 28th - D+70 Agent Orange’s Miracle

WARNING: This post contains a graphic surgical image. No blood though.

I’m running out of grandiose metaphors to describe my progress and journey back to fitness. Lazarus – tick. Phoenix from the flames – tick. Nelson Mandela – tick. So I am reduced to using Eddie Murphy in the film ‘Trading Places’.

Since first using the G-Trainer four weeks ago, the progress has been amazing. I gradually increased my bodyweight and combined with a punishing series of daily stretches and exercises, the improvement in flexibility and strength has been rapid. Two weeks ago, the Aircast boot was removed for good as I returned to work, and replaced with an Aircast stirrup (I’m expecting a Christmas card from Aircast Corp.) which is essentially a structured ankle brace that can be worn with shoes, and prevents my ankle from rolling over e.g. falling off a kerb, on the tube or breakdancing at a party.


Normally, the removal of the boot would mean a return to crutches but despite being tentative and a little nervous at first, I was able to walk unaided and barefoot at my first attempt (under physio supervision of course) – it was a fantastic feeling. It was at that point that I suddenly felt like Eddie Murphy’s ‘Agent Orange’ in Trading Places: “I can see! It’s a miracle!....I...I have legs…I can walk! Praise Jesus, praise Jesus!”


For my first 2 days back at work I wore the boot to commute to the office, then removed it altogether. Now, less than 2 weeks later, I am walking without any limp. My stride feels normal and not at all restricted. When no-one is looking, I sometimes do a little moonwalk across the carpet followed by a chimney sweep kick, and double-barrelled pistol shot in sheer glee at my mobility (I don’t really, but I feel like doing it).

There was however, a brief period of panic where for three or four days I was experiencing immense and sharp pain on the inside of my ankle – this was where the scan had showed additional ligament damage that the surgeon hoped would self heal through being immobilised. The alternative he said, would be keyhole surgery. I immediately feared the worst, picturing myself having to go through another bout of surgery once the lateral work had healed, this time succumbing to booze during my time off, growing a greasy beard, quitting my job and becoming a rambling alcoholic in my Brixton local: “I yooshed to play football you know.. yessh, fooball….I was rubbishhh…”. My fears were short lived – at my follow-up appointment with the surgeon assured me it was most likely due to reactivation of the ankle and foot and the daily activity it was going through. Sure enough, the pain has slowly ebbed away and I will see the surgeon again in 7 weeks.

The surgeon was also very pleased with my progress, describing me as well ahead of schedule. I have no doubt that this has largely been due to the intensive physio and the use of the G-Trainer which meant I was walking well before my Aircast was due to come off for good. I was amazed when Regan told me that most insurance companies don’t recognise it as a rehabilitative tool and won’t cover the cost of using it.

Slowly but surely, muscle tissue is returning to my legs and particularly to my left calf. Whereas four weeks ago I had the hairless leg of a young boy, I now have the hirsute leg of a skinny teenager. Progress.

A by-product of the daily exercises for my ankle and legs has been considerable soreness and tightness in my foot and calf. The solution to this was a deep tissue massage by Regan which almost brought me to tears. The only way to adequately describe the sensation was that it was as if each muscle fibre was being crushed into my shin bone, which itself was covered in small metal thorns. The extreme wincing and pained expression on my face went unnoticed (I think) and the alpha-male in me insisted on forcing out “Yes... I’m fine” through gritted teeth and a clenched jaw, whenever I was asked if I was ok. Imagine Alan Partridge trying to carry something that’s far too heavy for him, with a hernia, and being asked if he was ok – that was me.

I did have to attend my friends Dave & Laura’s wedding still wearing my ‘space boot’ (or Robo Stump as Jon R. calls it), but felt unencumbered by it after a few, ahem, social lubricants, and had a fantastic time. Next up, my brother’s wedding in Yorkshire this weekend, followed by Stevo’s stag do in Barcelona next weekend. I think I might keep the stirrup on for now.

And finally, my surgeon sent through a photo of my ankle mid-operation, which gives me a ghoulish sense of pleasure. Not in an erotic way, you understand, just as a reminder of how far I’ve come on the long road back to fitness. Opinion has been divided, with some people (mostly men) describing it as “cool”, “mad” and “mental” and some people (mostly women) describing it “sick” and “disgusting” and me as “weird”. There’s also some consternation at the complete absence of blood, with suggestions that I might be extra-terrestrial. Make your own mind up (and check out the split in the middle of the tendon):


For reference – my current rehab exercises:
Daily
1. Balance on left leg on uneven surface, rotating right leg: 5 x 20 secs
2. Calf raises, 70% of weight on left leg: 3 x 20 reps
3. Two leg squats: 3 x 20 reps
4. Calf stretch – leg straight: 3 x 30 secs
5. Calf stretch – right leg bent: 3 x 30 secs
6. Theraband stretch – inverse: 3 x 12 reps
7. Theraband stretch – lateral: 3 x 12 reps
2/3 times a week:
1. Thigh stretches: 6 x 15 secs per leg
2. Hamstring curls with ball: 3 x 15 reps
3. Leg press: 3 x 12 per leg, ~50kg
4. Bike: 20 mins at ~130 bpm

Stats & highlights:
Days back at work: 10
Current reading – Provided You Don’t Kiss Me: 20 Years With Brian Clough
Music: This Charming Man (The Smiths)
Reasons to be cheerful: 3

Thursday, April 9, 2009

April 9th - D+51 I Know Why The Caged Bird Sings

A lot has happened since my last post, and reviewing where I was 4 weeks ago, a lot of progress has been made. Around 3 weeks ago (4 weeks post-op), I was able to start walking without crutches within my Aircast boot. The extra mobility felt amazing in comparison to previously having to carry and fumble with crutches.
My physiotherapy has also progressed significantly – initially I had exercises to flex my ankle vertically and horizontally to reactivate the ligaments, tendon and muscle. Along with this were a number of static or low movement strengthening exercises to rebuild the leg muscles, particularly the hamstrings and quads. This has all now progressed to extended stretching exercises for legs an ankle (my flexibility has improved greatly) and additional strengthening exercises including using the leg press.

Most significantly of all, last week I started using the G-Trainer, a zero-gravity treadmill designed by NASA. This allows me to start ‘walking’ far earlier than normal, by creating a weightless environment from the waist down (see photos). Under Regan’s supervision, the weight was adjusted to around 20% of my bodyweight – and I started walking barefoot. It was a strange and unsettling experience, particularly since my left side is now very flat footed and over-pronates severely – I am essentially learning how to walk again. Progress has been quick; today I was walking at moderate to fast pace carrying 55% of my bodyweight.

The next steps are for the Aircast boot to come off next week, replaced by an Aircast ankle stirrup (I’m doing my bit for Aircast Corp. during the recession). Frustratingly, this means a return to crutches at first as my ankle will be highly vulnerable and less support.

One note of caution for anyone else who suffers a similar injury – last week, I hit the wall mentally and it will probably happen to you too. Until now I had been very matter of fact and positive about the 6-month slog ahead of me but it got the better of me last Wednesday. Despite the progress, I had set my expectations unrealistically high, expecting to be running soon. Instead, I was cautiously taking flat footed steps on the G-Trainer. Coupled with the sunny weather outside and the sight of lithe blonde joggers around Clapham Common, I suddenly felt frustrated and angry at having such a long recovery ahead of me and being unable to join in. This is, apparently, quite normal. I’m now determined again. Determined to be running in a month. Determined to be football training in late July and playing again in August. In a couple of weeks, I will be getting a personal trainer too. My goal for the end of the summer is to be bigger and stronger, and carved from mahogany.

Other news:
Suit fitting
My brother, his other best man and I had second suit fittings for the wedding. The tailor was highly amused by the apparatus on my leg, making a glib remark about “one flared leg” on my new trousers. He did however, describe my shoulders as “powerful”. That's good enough - when he measure my bakcside last time, he said "Ooh, you're not fitting into your last trousers anymore, are you sir?".


Stag do
Four days in Puerto Banus that were an outstanding tribute to the stamina and endurance that a male body can produce when it has to. Watching the game of volleyball in the pool from sun lounger was frustrating but the Aircast came into its own on nights out, attracting plenty of useful attention. Even more so, when I replied “Shark attack” to anyone who asked what had happened.


Albion Semi-Final
My team (http://www.albionfc.co.uk/) had a cup semi-final which I watched from the touchline with a cantankerous demeanour. We lost 5-2. I'd rather not say anymore. Except that my mate Dave managed to quite comically, break his wedding ring finger into a crazy shape - 2 weeks before his wedding.
Stats & highlights
Days until Dave & Laura’s wedding: 2
Current reading: On Chesil Beach
Music: One Day Like This (Elbow)
Liver & brain cells destroyed in last 7 days: ~1.5 billion