I originally intended to call this post “Eating Humble Pie”. If I am fully honest with myself and my readers, however, I realize I am not ready for a whole pie or even a whole piece. But I know I can handle a few bites. Let me explain…
The Humbling Situation
I’ve had complications from recent surgeries, as many of you know. Some of this I’ve said before, but in this recounting, I am being honest as to my responsibility in pushing too much too soon, the part that is hardest for me to admit — to myself and to others.
Right knee replacement, 11/14/16.
The aftermath of this has been pretty good, although I still have significant pain at times. Never having had a joint replaced, I don’t know how much of this pain is “normal” and when I should be concerned. I also have a distinct “clunking” noise and feeling in my knee each and every time I move it in a particular way. Part of the plan, or something awry? I don’t know. I have been assured and reassured that my knee replacement is solid, and that I can’t hurt anything. Those are dangerous words for someone like me, who can and will put up with a lot of pain to do what I love. I was out on trails and walking as early as 3 weeks after this surgery. The complexity of the knee replacement was furthered when, at just 5.5 weeks post op, I had foot/ankle surgery on the left side. I was on crutches in various capacities for 5 weeks after that surgery, using the right leg for full weight bearing. That was, simply put, hard on the new knee. Now, 3.5 months post-op, I am still with pain and uncertainty about the status of my knee.
Left foot/ankle surgery, 12/22/16.
This recovery started out fantastically, the best yet of all eight foot/ankle surgeries. I was walking without crutches early, and taking long hikes in the post-op boot — feeling on top of the world and certainly my recovery. Then, a fall in the snow over three weeks ago caused an initial setback, from which I recovered quickly after five more days in the boot. I took myself out of the boot and started walking again, believing I was ready. On each of my first five days post-boot round two, I walked. The mall on day one, Lake Padden on day 2 (2.6 miles), the interurban trail on day 3 (4 miles), adding slightly more miles each day. Each day I noticed a bit of pain in my forefoot, but told myself it was nothing. On day 4, I walked Lake Padden before work, worked all day, then walked it again after. A very normal activity for me, usually. But by the second walk, I could barely do it and hobbled all the way around. I knew something was up. Again, I told myself it was just muscles in my foot getting used to working again after being on vacation for 7 weeks…but deep down, I recognized that the pain was different. Stubborn as I am, on day 5, I took a scheduled walk with a friend, but I was limping so badly I could barely walk. I am embarrassed to say I walked five miles like that, each step a painful reminder that I shouldn’t keep going.
It was all I could do to keep a shoe on after that walk. My foot was swollen and very tender. But I went about the rest of my day, which involved an outcall massage, all the while trying as hard as I could not to limp. It was almost impossible, but I am good at compartmentalizing pain and discomfort, physical and emotional, and did what I needed to do. The massage finished and back home, I took my shoe off to rest my poor foot. It was inflamed and exquisitely alive with pain, the kind where you don’t even want to touch the affected part. I hoped and prayed it would recover overnight. That wasn’t completely out of line, as many times on long hikes or after intensely physical days, I go to bed with significant aches and pains that DO almost magically go away overnight….or at least move again to a manageable level.
But this was not a normal ache or pain, I could tell. Tuesday morning, day 6 out of the boot, I still couldn’t walk without a significant limp. The pain was intense with every single step. Fortunately, I had my six week post-op check that morning. (I was actually almost eight weeks post-op: for various reasons, all related to weather, either the office or I had to cancel two previous appointments). The reason I mention this is because I had to, or chose to, make decisions during this two week time frame about how and what I would do. I even went so far as to email the PA and tell him after the first appointment cancellation that I was taking myself out of the boot, and I hoped that was ok. To his credit and my discredit, he replied that he could not medically authorize that without seeing me and getting x-rays first. I chose to be rogue and go AMA (against medical advice), and I paid the price — twice. First with the fall on my first day in round one without the boot, then with the whole episode of progressively worsening pain in round two walking in shoes. THIS was my first inkling that there was pie to be eaten…
The current reality…
I hobbled to my visit with the PA, on day six of round two AMA. I told him the whole story, and confessed all my transgressions. I’ve seen the same PA for most of my post-op visits, and he has been involved in at least two of my four foot/ankle surgeries with my foot surgeon, Dr. T. Both Dr. T and the PA know my feet, ankles, and psychology well! Including my desire and need to get back out on the trails as soon as possible after surgery. To a degree, they both endorse this, as long as it doesn’t jeopardize their surgical work and my recovery in any way. This time, though, the X-rays showed a new stress fracture in my foot, and that really put me in my place. The surgical sites and structures were well healed, but this new problem had crept up quickly. In short, my walking too much too soon once out of the boot led to the development of a stress fracture in the third Metatarsal bone. Perhaps the bones were softer from not being used, and apparently I went at the walking too aggressively, relieved as I was to finally be out of the boot. I have had a stress fracture before, and the pain and symptoms certainly fit with his diagnosis. The way I left it with the PA is that I would rest the foot for four more weeks, then return for further X-rays. And no more walking of any distance without the boot. I left the office humbled and depressed.
The aftermath…and a few words about my psychology.
I lasted three full days without a walk. During that time, I sunk deeper into depression. Here is where things get interesting. I write this believing that some of you can relate to my struggle for balance. Sharing and being honest and forthcoming about this part of my psychology is both an attempt to explain WHY I continually push the limits of what my body will allow physically, and an exploration into the whole question of “how much is enough, and how much is too much?” I am not ignorant or unaware of the risks or trying to put my recovery in jeopardy. I do these things because, deep down, my NEED for some type of physical movement and especially contact with the outdoors is deep seated and real, such that I will go to extremes to make it happen. THIS particular struggle and balancing act, how much I can do following injury, surgery, or some other medical issue, has been a constant companion in my life for over 30 years. My stories about getting out too soon following something run round in my head like a broken reel tape. Why, then, don’t I stop pushing so hard? Why not just sit around and do nothing for days or weeks on end, letting my body heal and trust that things will take their course? To my credit, I can and do usually do that for at least a week following surgery. Then, my restless nature gets to me and I start scheming ways to get out and about.
It’s always the same, the struggle to know how much is enough and what is too much. I tend to err on the side of the latter, yet my ongoing quest is to find the former. Exercise and endorphins are addictive, yes, but I don’t need that so much. What I need is to be outside. Some part of me dies when I can’t be. For me, walking trails and being in nature feeds my soul to an immense degree. Hence the name of this blog, and my whole pursuit of walking, hiking, and backpacking. I am driven to go and to be there, in whatever capacity I can, and as soon as I can. So, after three days of no walks, being inside and sinking further into depression, I decided to go back into the boot for walks and hikes outside. The boot was and is trashed and duct taped almost beyond repair, and had to be retrieved out of the garbage. But I made a decision on that Friday, three days after my visit and diagnosis, to go back into the boot and hike for the remaining weeks until I return to the PA for x rays. I had to restore balance.
The next steps…
It’s been two weeks and a handful of days, and the hiking in the boot strategy is working! My foot is much better, and I have stayed 100% true to my pledge and promise not to hike in a shoe. I have taken hikes to places and in conditions that I would have missed had I not gone back to the boot. I am working and doing daily life in street shoes, a compromise the PA and I agreed upon. I can say with conviction that healing is taking place, and I am happy about that. And I know I will stick with the protocol. My knee, always troublesome, is another story. In the spirit of non-denial, I made an appointment this week to see the knee surgeon, to determine if the pain and clunking is normal or something to be concerned about. I will take his advice to heart, and that’s a promise too.
But here is what I know. I know this “enough/too much” battle will continue. I am not out of the woods yet, I may never be completely. I get humbled by these experiences, and I do learn my lessons. I do take bites of that humble pie, and I think about what it would take for me to eat the whole thing. But even as I do so, I know my tendency will always be too get out just as soon as I can, and sometimes that will be sooner than ideal. SO many people in my life have told me to be careful, to slow down, to not be so driven, to cut back. For all of those, I take a bite. I am aware I “use” exercise and movement as tools to keep myself sane, no question about it. I am reliant on that, and it is hands down may best coping mechanism for dealing with stress. Sometimes it’s too much and too soon. What I want to say is that I AM listening, and that I am getting the message!
It’s a work in progress, and a repetitive theme of my life — not just with exercise, but in all areas. As I work on writing my memoir, I am exploring this theme of how much is enough and what is too much, in depth. I have settled into my exploration, with full awareness of my tendencies, and full commitment to discern for myself my own boundaries in this area. I will continue to share on this topic, and would welcome your thoughts. EVERYONE has an area of life in which they must ask themselves these same hard questions. I believe that by getting open and honest about our deepest areas of struggle we can make headway into dealing with them.
My hope is that, by writing this post and laying it out there, you may be inspired to ask yourself the same hard questions. Where in life do you push too hard and pay a price? Work? Over commitment? Lack of sleep? Poor nutrition? Substance use? Care-taking others over yourself? Too much electronic escape? When is it all enough, when is it too much? Unquestionably, life is a long , sometimes arduous, complicated journey filled with ups and downs. Sometimes, it’s only about surviving and making it through one day at a time. We all have our fallbacks and coping mechanisms that we use to get through these times. Some are clearly more destructive than others. I am the first to admit I have dabbled and jumped head on into far more dangerous territory than reliance on exercise in my past. I have conquered significant mountains of overcoming, the specifics of which I am currently reliving as I write my memoir. On the whole I feel quite satisfied with where I am in my ongoing quest to find balance in life. Right now the exercise vs. rest is my biggest challenge.
What is yours?