Friday, 21 April 2017

Day 2 Post Op

Right now, it is exactly 48 hours since I had surgery. I had surgery on April 19th. I went in at 11am-ish, And I came to in recovery at 12:20pm. I remember because while the nurse took my obs right after I woke up, the old lady in the bed next to me was confused and asking lots of questions. One question was what the time was.

Mum drove down the day before. I worked a long day to make up for my missed hours and got home to find mum had cooked me a roast chicken- yum! Then i followed the usual procedure, No food after midnight- no water after 6am. Was up at 6:30 to do a chorohexidine sponge wash. No skin products after that so Joelle my Beauty Therapist is probably going to shoot me. We've been working so hard to get my adult acne under control.

Then off to the hospital at 8am. When I got there they had me change into a gown and gave me a loading dose of paracetamol. They don't let you wear anything under the gown. At my insistence I was given a pair of flimsy mesh underwear. But no bra. I sleep in a bra so I was unimpressed. So then mum and I sat there till 10:30. We just talked about everything. Life mostly. at 10:30 the anaesthetist came in. We had a quick chat. He confirmed some details and then disappeared again. About 10 mins later in came my surgeon. He marked my legs, just giant arrows with sharpie and answered my last minute questions, confirmed the number of compartments we would be releasing etc. Then he was gone too. Lastly the nurse came in. Checked I was good to go, answered my questions (your not going to catheterize me are you?!) and then she walked me down into theatre. In theatre there was the anaesthetist, and some nurses. They had me lie on the table, covered me in heated blankets. Then they put in a line. I remember being given an oxygen mask- but it smelled weird- i remember thinking that's not just oxygen. They told me there was gas in it to help settle me. I felt a bit drunk, tingly and weird. Then the nurse gave me her hand to hold, and last thing i remember is the anaethesist saying he was going to put me out. I don't remember closing my eyes or going out, but I do remember coming to.

Coming too was weird. It felt like coming back after fainting. I had semi dreamed. There was one nurse with me, And I was really groggy but i fought to stay awake. They told me once I was awake  and my obs were stable I could go to the ward which was where mum would be. I don't know why but I just really wanted to cry. It was only about 10 mins later they took me to the ward. I was put in a 4 bedded room (public health) with 2 other post surgical ladies. They were feeling really sick from the anesthetic too so we didn't really talk. I was nauseous too when i first sat up. i lay back down quickly. I would've vomitted if I had anything in my stomach. The nurse gave me anti-nausea drugs through my IV and I instantly felt better. I had mum help me change into PJ's and my own underwear as soon as I was no longer nauseous and able to move in bed. I felt so much better in my own clothes and a bra.

I walked for the first time an hour or so later. A nurse on one side, HCA on the other, doing this really weird shuffle. My legs didn't hurt too much, but it didn't want to bend my knees. I sat on the toilet and i started to feel really dizzy. I managed to finish my job and pull my pants up, then sit back down on the closed toilet seat before i rang the bell but the HCA had to wheel me back to bed. I launched myself onto the bed and lay down and felt so much better instantly. The nurse gave me another anti nausea drug, this time sublingual. I spent most of that day lying in bed dozing. Occasionally watching some shows on my laptop.

I stayed in bed till after dinner. This time I got up and had the nurse walk with me but i was much more steady on my feet. I walked back from the bathroom myself and from then on was good to walk alone. My pain levels kicked up over night. The Dr's had put a local in at the end of surgery and that started to wear off I think. I was numb on the inside of my ankle that night but I could feel that again when I woke up at 11:30. I had lots of paracetamol and tramadol overnight. I think alot of that was because my sleep was shit so I felt the pain. There were machines beeping and we got a new room mate at midnight. Then another roommate was nauseous. All that hospital fun.

I was discharged after a surgeons visit, a dressings change and a shower the next morning. I was able to shower myself, though I used the shower chair. and get myself dressed. We left hospital at 10:30am and I spent most of the arvo sleeping. Mum woke me up for dinner and I was up again till I went back to sleep at 10pm. Holy hell though last night was the best nights sleep I've ever had. I feel normal again now.

Mum left to go home this morning. I'm waiting for my boyfriend to finish work and come around for the weekend.

My pain is good. I was discharged with paracetamol, Tramadol and asprin. I've taken the paracetamol today but haven't used tramadol since yesterday, The asprin is just as a blood thinner so its low dose and I take it once a day. Over all my muscles are achey. There's no pain if I'm still, when i move they feel like a tight crampy feeling. Like after a really bad muscle strain. There a little burning in my legs where the incision is and they are also tender. But overall its like really bad sore muscles after leg day when I walk. I am walking, but just to the bathroom, kitchen and back. I was able to walk into the pharmacy yesterday too. I am walking hilariously though. Kind of like a toddler. For some weird reason my Right leg hurts a bit more than my left, but its managable. I am noticing a bit more ooze on my R leg wound though, So I may go back to the hospital soon if it continues, for another dressing change.

My stitches come out in 2 weeks and i have a ortho follow up in 6.

All in all im ok. Im a sorry sight, but im ok. with any luck ill be back dancing in no time.

I cant wait for Mark to get here though. I have a weekend of cuddles and movies planned. And maybe for the second time in our relationship he might just cook me dinner :)

Thursday, 22 December 2016

Chronic Exertional Compartment Syndrome- A 10+ year journey.

Something big happened in my life last week. But in order for you to understand why its so big for me, I need to start at the beginning.

I have danced all my life. I started ballet when I was 4, competing onstage for the first time the same year. I started pointe work when I was 11, and I was generally an active kid. I did triathlons, gymnastics, swam competitively, and I loved camping and the outdoors. But it was ballet that was my main focus. When I was 13 or 14 I started getting cramp in my legs in class. At first it would be just a bit of cramp, easily stretched and rested for a few minutes, then get back up and keep going. Then it developed into something else. It was this constant burning cramp, but stretching it only made it worse. Allegro and pointe work were the worst. But other than dancing, walking up hills and walking longer distances in jandals, nothing else made me have this pain. I complained of it for awhile, but i was just told that feeling the burn was good, because my muscles were working. That i needed to suck it up and get going.

Around this time there was a girl at my dance studio who was diagnosed with Chronic exertional compartment syndrome (CECS). A condition where your muscles are too big for their fibrous sheaths, so the pressure inside gets too high and your blood flow becomes compromised. Your muscles literally strangle themselves.

It wasn't until winter school when I was 15, at the NZSD, that things really got bad. 6 hours a day for 5 days of dancing. I was in agony. Mum gave me supplements to help reduce the cramp. I was chugging magnesium melts so much my poor liver probably still has damage. But it didn't help much. I gritted my teeth and got through it. Mum started to wonder whether I might have what the older girl had had. By this point I had stopped almost everything but ballet. Partially because I wanted to focus on dancing, but partly because I was just in so much pain.

After mum talked to the mother of the other girl, we went to my doctor and requested a referral to the same surgeon that had done her surgery. That summer, dad and I flew down to wellington, and had a consult. The surgeon agreed that I was describing symptoms that matched CECS and organised the pressure testing for the same day. I was booked in for surgery too. There was a hill up to the hospital, so when it came time to bring on the symptoms, i just went for a wander up and down the hill. The tech very carefully and slowly put anesthetic into the injection spots, and then he very slowly jammed this giant needle into my legs- multiple times. It hurt so much! It was like i could feel the giant needle grating against my bone! By that point the pain in my legs had long subsided and I was feeling every bit of the needle (did i mention the anesthetic didn't work properly on me till after the procedure? thanks genetics!) Even worse than the pain, was the test results- Negative. So the surgery date was cancelled, and I was sent back to my GP. With no cause for my pain.

Around this point I started to assume that I was really just a big wuss. That this pain was a normal burn from exercise, and that if everyone else could deal with why couldn't I? The PE teachers at school told me to suck it up, if I didn't have a note then no I couldn't stop running in PE.

When I was 16 I sat my RAD Advanced 1 exam, and I walked out of the exam crying from the pain. I swore I would never sit another exam again, and to this day, I still haven't sat my Advanced 2 exam. When I was 17 I hung up my pointe shoes and went off to uni, to study Physiotherapy. I lived in Dunedin, where my main mode of transport was walking, and hills were abundant. I was always trailing behind everyone else. I was called lazy, unfit, slow coach, wuss, pathetic, attention seeker etc by people I no longer consider friends. And I believed it alot at the time too. But since walking uphill was the only time I had pain, I just struggled through it, and avoided hills like the plague. I often would walk the longer route home if it was flatter.

I went skiing during my first year, and that was absolute agony. I had been in these boots for all of 30 seconds when the burn started. It was so intense and it took me by surprise. My closest friend at the time was not very sympathetic. As I tried to hold in tears and work my way up the slope, she told me I was being pathetic and ruining her ski trip. Something she repeated the next day when I complained about having to walk up the hill to the Queenstown gondola. I discovered if I undid the top straps of the boots, my ankle wouldn't be forced into the dorsiflexed position and the pain was much more manageable. Of course anyone who has been ski-ing knows this is a no-no, and leaves you vulnerable to fracturing your ankle if you crash. Luckily, this didn't happen to me, but I did get told off a few times by mountain staff, and no-one seemed to care when I was in pain.

I made do for 5 years at uni. Every now and again I would decide to go for a bush walk with friends, every now and again I would trail behind and was reminded why I don't do that anymore. After I graduated i signed up to do the RAD ballet teacher course, and I started dancing again. I got back en pointe and started doing Advanced 1 class 2-3 times a week. The first 6 months were fantastic. But the pain returned the more dancing I did. Being a physio now, and having tried everything I could think of to relieve the pain, I went back to my doctor. I requested a referral for more investigations, but this time through the public health system. I had x-rays, ultrasounds, consults etc. And finally, almost a year after my referral was made, I had pressure testing again.

This time was very different. I went to the studio for an hour before-hand, I tried to bring on the pain but it wasn't as quick to show this time. I had had nearly a month off dancing and I dont walk as much as I used to, but I made some progress. Then at the hospital I walked on the treadmill, and brought the pain on much more there. Then we quickly sprinted down to HDU, I did some calf raises to bring the pain on nice a freshly, then jumped on the bed and the surgeon jammed the needle in like a dart. It was very sudden and a quick sharp pain but over very quickly. It hurt much less and the result was positive! He tested a few other compartments, but I struggled to do calf raises properly after the ache from the first needle going in. They were all moderately high.

Now I'm on the waiting list for surgery, and it looks like it will be done sometime in the next 6 months. I cant wait to be able to walk, and keep up this time. I cant wait to dance without pain. I am so glad to have an actual medical reason why I'm in pain, and better than that, a light at the end of the tunnel. I cant remember what it feels like to dance, or walk up a hill without pain. I cant wait to experience it.

Which brings me back to the reason for my writing this blog post

1) To everyone who ever called me pathetic, or lazy, who didn't care when I said I was in pain and told me to suck it up and hurry up, most of whom wont ever read this because there's a good reason I cut you out of my life, screw you. You have no idea what I was dealing with.

2) I hope that anyone else who is experiencing symptoms like these doesn't let themselves just be sidelined like I did. I regret so much not demanding more answers. And I knew when that needle went in during the first testing that the pain had gone. But I figured they knew better than me and that they would find out what was wrong. When you know somethings not right, keep going until you get answers. You deserve it.