Friday, February 3, 2012

Compartment Syndrome Diagnosis, and the Dreaded "S" Word..

What started as an annoying injury in early 2011 is going to end in surgery sometime this spring. Yes, the same spring in which I was supposed to run the Eugene Marathon, and lay down a marathon PR on the track at Hayward Field.

Compartment Syndrome was the suspect, and was confirmed when I went to see the MD on Wednesday through an Intra-compartmental Pressure (ICP) Test. This test is considered the gold standard diagnostic test for chronic exertional compartment syndrome (CECS) in terms of accuracy and reproducible. However, it is a painful and invasive procedure, which relies on the skill of the tester. In spite of those disadvantages, pressure measurements are the only available objective test. Can you tell I've done my research?


I was told to bring on the symptoms in my leg as much as possible in the couple days leading up to the pressure test. So I managed to pile of miles, some speedwork, AND hill repeats, because why the hell not. I was also told to wear my running attire and shoes for the appointment, as there would be a little running involved. Mmmkay.

Doc comes into the room, we talk marathons, and I explain my story. He gets nearly giddy about the potential of driving many large needles into my leg, and gets to work. I get an injection of Novacaine into each the 4 different compartments in my lower leg.


 Sting and burn. Sting and burn.

Then we get into the really fun stuff. Doc pulls out one of these fun little pressure meters


and starts to beat the snot out of my lower leg. One of these babies in each of the four leg compartments. Holy hell that hurt. I put a short video below of (part of) the procedure, but be warned, it's kinda nasty.



After the first pressure readings were taken (including novacaine, we're up to 8 needle sticks now), Doc tells me to go for a 20 minute run outside, and so kindly provides me with a loop. Errr.. Am I on candid camera? You want me to take my partially numb, bleeding leg, and go beat the crap out of it? There has to be a punchline, right? Apparently there wasn't. He told me to jog in place in the exam room upon my return, and to not stop moving until he was back in the room with me. 

One of the many things I learned Wednesday? Running on a numb lower leg is a trippy sensation. Luckily, my foot still worked, but my leg was partially numb, and my left leg was just angry that I was out pounding out more miles. Super. 

Back into the exam room, while being barked at by the nurse to continue running in place. It was the closest I've ever come to boot camp I think. Doc saunters into the room, instructs me to keep moving until he's "ready". Once he gets gloved up again, he tells me to lay on the table, and goes after those compartments again with the above torture device. Although the bonus this time is now I'm dripping sweat all over an already gross exam table and my HR is about 354. Try not to be jealous. 

When he's done, I start to get up. "Lay down, and please be still" he says. "I'm going to go get you some water, and we need to do this one more time in 5 minutes". I start laughing, and say "oh, you're hilarious". He gives me that blank doctor stare and says "I'm not kidding". Oh. 

After 5 looooooonnnggg minutes, in which I seriously debated bolting from the joint, he comes back in for another go-round. For those keeping track at home, this would be round FOUR of needle sticks, bringing the grand total up to SIXTEEN. No, not a typo. 

As he stands over his laptop, staring at some notes, he sighs. I ask what's up, and he says he needs to test one compartment ONE MORE TIME. Before I could jump off the table, there was a needle in my leg. Again. 

Finally done, he wraps me in lots of gauze and ice, while trying to break the news to be gently. 


Three of the Four compartments in my leg need to be relased via Fasciotomy, which is a surgical procedure in which they cut the fascia to relieve tension and/or pressure. 

Yes, you read that correctly. Surgery. This spring. Which means Eugene is no longer. And my sucktastic 2011 season of running continues to bleed into 2012. Awesome. 

There IS a silver lining however; more than one actually:

(1) I can run right up until the surgery, which will be no sooner than mid-March. And in that time I plan to race a 10-miler and potentially a Half Marathon. I'm going under the knife in the best shape possible. 

(2) This surgery is removing the problem that has been plaguing my training for the last couple of years. When I come out of this, I won't be sidelined by this injury ever again. And that is so damn sweet. If it happens to ever occur in my left leg? I'll take up a new sport. 

(3) While I don't know the specifics until my consultation, it doesn't appear that the recovery is too daunting. 

(4) Given the timing of the surgery, I'll have plenty of time to come out of this and train for a kick-ass late fall marathon. 2012 can still be recovered! 

More to come, but that's the current status. I'm finally not limping around today, and managed to hop on the trainer for a little bit earlier. And my plan is to try for an easy run tomorrow, and see how the leg post-jabbing holds up. 

Stay Tuned... 

Happy Training! 

27 comments:

  1. I am so sorry to read this! BUT, you're right, the season can still be salvaged and, more importantly, you'll never have this again which is pretty awesome. Thinking about you and hoping the recovery is quick!

    PS - I couldn't watch the video :)

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    1. Thank you thank you! And hahaha, I was going to take a poll to see who actually DID click on the video. I watched when he started on the first one, and then had to look away.

      We should do Eugene together next year - you up for a repeat?

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  2. Oh my - that whole procedure sounded like torture! I hate, hate, hate that you are missing Eugene but it sounds like you have a good attitude about it. In the end, it will solve your issue and you will be faster than before, right?

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    1. You're correct, and while not ideal in the short-term, I'll get huge long term dividends out of it. Eugene will be there next year :) Hope you're well K!

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  3. Holy crap. That was INTENSE to watch. You are seriously so strong, girl. I have no idea how you got through all of that!!!! AND the sheer fact that you identified so many silver linings to this is amazing to me too, you have a GREAT attitude about this which means you're gonna soar thru this thing so much stronger and better on the other side. I love it.

    PS. late-fall marathon...how about Chicago, with moi? ;-)

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    1. Thank you :)

      And I wish, I LOVED that race - but I'm going to need something a little further out then Chicago.. I might still go and cheer though - I love that city!

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  4. OK, I can't watch the video, but really found this post intriguing. First of all, you are amazing to push through the pain that you have for the past year. Second, you are brave to go through that testing. Love that you had all the research so you knew what you were in for. Third, love your attitude. You will come back from this, the amazing runner that you have been shooting for for years. Good luck and let me know if there is anything I can do to help you in the next few months.

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    1. Thank you Robin, I appreciate it :) I'm hoping to come back and lay down a kick-ass marathon PR in the late fall!!

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  5. Wow. I am so sorry my friend!! That looks so intense too, I can't even imagine! I hope we can meet up for a run before you can't for awhile...and I love the idea of Chicago too hehe, since I'll be there cheering Jess and Sam on! (selfishly speaking). XOXO

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    1. I would love, love, love to go to Chicago - they can run, we can bring water bottles full of wine! Everyone's a winner :)

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  6. So I watched the video, and then looked up fasciotomy, and now my stomach is in knots. Wow. I'm sorry you have to deal with this, but it'll make your running so much stronger going forward. Keep us posted!

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    1. Its like a trainwreck for nerds - you start watching one of the videos, then you wikipedia the terminology, and you just can't stop watching ;) I'm also confident that I'll come out stronger - thank you!

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  7. While I will not watch the video I look forward to your speedy recovery! Best,
    Josh

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  8. Sorry that you had to go through all that but at least you know the whole story now. This kind of stuff sucks but I am sure that it will make you come back stronger than ever. Hang in there!!

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  9. Mystery solved.....now to fix it. Yay for fixability :)

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  10. Oh gosh lady I am so sorry but glad you got answers!!! We will cheer each other up tomorrow by running together. I will give you a big hug which will clearly make everythin better,clearly

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  11. #2 was my first thought when I read the first part of this post: just think how much faster you will be!! Also think you are really smart to go into the surgery in the best possible shape as that will indeed make your comeback so much quicker.

    definitely not all bad!!

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  12. Holy medieval torture Batman!!! Sad to hear that surgery is on the horizon ... but you'll get through it!!

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  13. oh good lord alive, i'm so sorry friend. BUT i'm glad that it can't come back after the surgery and you can keep running until them. sigh. hugs to you!!

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  14. Wow....if you survived that diagnosis you can survive anything. I'm so sorry about Eugene, but glad you get to run up to the surgery and glad that this should fix the problem.

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  15. Oh my goodness! A) This is the craziest diagnosis I have ever heard of and B) I'm so, so sorry. This will definitely tough and I can only imagine the emotions that you're going through right now, but I suppose it's part of the journey. Things that happen in life that make us appreciate the other things that much more. Both Lola-Puppy and I send our thoughts of a speedy recovery your way.

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    1. Lola-Puppy!!! And thanks Page - really appreciate the note!

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  17. Hi Meaghan,

    Oh my gosh, that all sounds HORRIBLE! I am trying to figure out if I have compartment syndrome and I was wondering if you could let me know what your symptoms were like as you were going through all this? I've read a lot of descriptions of the condition online, but I haven't really heard any first hand accounts yet (which I think might help point me in the right direction). Sorry to dig up old and probably painful memories! I hope you've made a full recovery!!!

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