Monday, August 27, 2018

Peroneal tendon surgery part 3: the end?

I keep waiting for some sort of obvious "finish line" to signify that it's time to write a final wrap-up of the outcome of my injury and surgery.  But since I don't have a good idea of what that finish line would look like--running a race?  not thinking about how much my foot hurts every time I walk anywhere?--I decided that the triple achievement this week of wearing normal running shoes instead of hiking boots for a run, finishing a hard race, and filling out a weekly training log that wouldn't be too out of place in my pre-injury training would be good enough.

Sometime in June I got completely fed up with my situation and was saying to a friend that it had gotten to the point where it felt like I would never get back to normal running.  He replied with the excellent point that it might well not ever go back to normal, but that it might not be better or worse, just different.  And this is exactly what I've found.  Unless I get a revision surgery (more on that below), my ankle is always going to be weak.  This is just what happens when you're missing a major ankle tendon--you can only train the surrounding muscles so much, and you can't train something that's not there.  I may never be fast on technical ground.  I may have to wear my heavy, uncomfortable hiking boots in races for the foreseeable future.  I may be even more pathetic than I was pre-injury on steep downhills, even though my pre-injury standard is a standard that's difficult to fall below!

But...I may have been forced into a decision about what types of races to focus on, which might make me faster in those races eventually.  Since I can't run downhill very well yet, I've started running some uphill vertical races, which I'm not totally sold on yet but may grow into liking.  I am becoming more efficient about making my mileage count, because I can only do a fairly limited amount of miles.  And possibly most importantly, I discovered that there's nothing like being unable to run for six months to teach you exactly what kind of running you missed the most, which is very useful for deciding what type of running to do when you are finally able again!

So, it's different.  If I could choose, I would opt to have not lost a foot tendon, along with vast sums of money spent on medical care, not to mention six months of my life.  And it certainly grates on my mental well-being every time I think about how the outcome could have been improved had I not picked such a lazy and/or money-hungry surgeon.  But given that this is the situation that exists, it's not all bad by any means, just different. 

It's not yet clear whether this is the end of the saga or not.  When I saw surgeon #2 in March, he was somewhat appalled at what surgeon #1 did ("Why did he do that?!" was the exact reaction, which definitely made my heart sink a bit...) but he wasn't particularly positive on the idea of a second operation to try to repair the damage.  His thought was that he might be able to fix what surgeon #1 did by creating a new peroneus brevis out of my FHL tendon, but he felt there was a good chance I could come out of a second operation in even worse shape than I'm in now.  His advice was to only get the second operation done if I were very unhappy with my running ability after 9-12 months of rehab.  This was exactly the same advice I got from another good foot surgeon via email, so it's promising having the two opinions coincide.  I'm currently at 7 months post-op, and given the massive progress my foot has been making the past few weeks, I think it's unlikely I'll go for the second operation, unless running in the mountains proves to be too much for the current repair and it fails.

I'm never one for the whole "just be optimistic" outlook--you don't build new tendons out of optimism.  But I do have to mention one of the big positives that came out of this injury, and that is the people who were a part of my recovery.  That started right from day 1, when two now-friends who I had only known for 12 hours came to rescue me from the hospital on a cold winter night, followed shortly by Divesh rescuing me from my hotel room of doom. Then there was all the help and support from friends and family while I was on crutches, and finally there were the new people I met because of the injury, such as my injury twin Diana, and Jordi, the world's best physical therapist, who is a rehab expert and all-around excellent person rolled into one.  If there is at all a good part of being injured, this is it.

And now?  I've made a list of all of the things I missed out on while injured, and I'm going to be making my way through it over the coming months.  And if all goes really well...I'm entered in the 110km Ultra Pirineu for September 29.  Even 40km is currently a very long way for me, so I'll have to see what my ankle says about the idea of 110km in only a month's time, but if it's possible, I'll be there!