Be Awesome Instead

I had a feeling the last few days were too good to be true. Minimal pain, no nausea, and a good night’s sleep the second night after surgery? Seriously? Well, at 2:30 a.m. today I woke up with a horrible stomachache and spent the next eight hours miserable and sick. There is nothing that feels more pathetic than being 26 years old, throwing up the entire contents of your stomach, and calling for your mom to come pick you up off the bathroom floor because you can’t stand up on your own.

I called the doctor’s office as soon as they opened, and they suggested stopping my prescription painkiller (it’s about time to phase that out, anyway) and seeing if Aleve and extra-strength Tylenol are enough to keep the pain in check. So far, so good. I slept for most of the day and have been trying to refuel on Gatorade and crackers — being so sick made me feel weak and exhausted. I butt-crawled up the stairs to get dressed around noon, and just doing that completely drained my energy.

I’ve actually slept a lot since surgery, period — the prescription pain pills made me tired, and I’ve been having a hard time staying awake through any of the books and movies I brought with me! I hope this means my body is dedicating all of its energy to healing. Plus, I find inspiration in the words of Barney Stinson a Greek philosopher, who once said, “Whenever I start feeling sick, I just stop being sick and be awesome instead.”

So, it's been a rough day, but I’m hanging in there! My surgeon called Wednesday afternoon to see how I’m doing and suggested that I try to put weight on my right foot (with crutches) starting Thursday. I was able to walk around for a little bit yesterday before heading back to the comfort of my cryocuff, AKA my new best friend. I’ve been keeping up with my exercises and cryocuff the best I can with my crazy sleep schedule, and hopefully by my one-week follow-up appointment on Monday I will be putting weight on my foot more or possibly using just one crutch. 

Until the next update, a few pictures:

What I wake up to! Fact: chocolate and peanut butter treats speed healing by 50%.

 

The sweetest get-well card from my favourite Brit, Kate!

My route to the couch, blocked by the alpha beagle. (This was taken yesterday...ain't no one going to see my sad self today!)

Here's My Ankle, So Cut Me Maybe?

I’m alive! At least that’s what I proclaimed as I left the operating room yesterday afternoon, according to the nurses, along with “Dr. Porter rocks!”

I’m back at my parents’ house (about an hour from Indianapolis) after my surgery, and am happy to say that I’m feeling better than I expected. My husband Eric and I drove up here Monday night so we could save ourselves a few hours of driving on the day of surgery. Determined to enjoy my last few hours of eating and drinking before the anesthesiologist-mandated cutoff, we went out for a delicious dinner at a local Italian restaurant. I chugged several glasses of water in an attempt to store up my reserves, camel-style, then came home for dessert: a chocolate peanut butter banana icebox pie (!) my mom had made from the latest issue of Southern Living.

OMG. All the things!

On Tuesday morning, I put on my Threadless “Swan Kick” T-shirt as a good luck charm (it shows a ballerina kicking a ninja through the air with her mighty arabesque), and we hit the road. I had to arrive at the surgery center at 10 a.m., and surgery was scheduled for noon. Once a nurse called me back, had me change into a hospital gown, and started a saline IV, my mom and Eric got to come back and sit with me. I had started to get nervous, not to mention thirsty!, and it helped a lot to have them there to distract me.

Dr. Porter came in around 11:15, explained once again what would happen in surgery, and wrote “YES” on my right foot. I asked if I could keep the bone, but that was a no since it’s live tissue, which isn’t allowed to go home with patients. Dr. Porter asked if he could say a prayer over my foot before we went into the operating room, which was so comforting and meant a lot to my family and me. He said we would get started a little early (a medical miracle!), then a nurse had me hand over my glasses to my mom and held my hand to walk me into the operating room. My vision is terrible, so all I could see was a big, bright room with five blurry people inside. All of the nurses were so sweet, and they had me lie down on a bean bag on the table, which helped keep me from moving around because I was lying on my side for the surgery. I was under a warm blanket and couldn’t help thinking the whole setup would have been cozy with a book and cup of tea…if the room weren’t freezing cold and scalpels weren’t involved. The anesthesiologist told me he was putting “I don’t care medicine” in my IV, and seconds later I was out.

The next thing I remember is Dr. Porter telling me he found and repaired a “good-sized tear” in my FHL tendon. The tear was about 2 inches long and the tendon was torn halfway through, thanks to the pesky os trigonum (which is NO MORE!) rubbing against it. The bone was “wiggly,” he said — fractured but still attached by some tissue. It blows my mind to know I had been walking and dancing on a torn tendon and a chunk of broken bone, but the new info also reassured me that surgery was absolutely the right choice.

I stayed in the recovery area for a little while and drank fruit punch Gatorade with ice…the most refreshing thing ever after 13 hours of nothing to drink! The nurse told me I came out of the OR chatting away (see the first paragraph in this post…) and that I asked to sit up and look at my foot in the boot. I have no recollection of this, but apparently it only took me a few minutes to wake up after surgery, so I think the anesthesiologist was right on the mark. I was amazed at how alert I felt, and I wasn’t nauseous at all. After changing back into my clothes, a nurse wheeled me out to the car, and we were on the road home by 2:00.

At home I went through the post-op packet, which included a get well card signed by Dr. Porter, the anesthesiologist, and all of the nurses (so sweet!), a crazy-long list of medications, and a picture of my snazzy new ankle, sans os trigonum!

I see why they told me I need to be out of work for a week: No joke, it’s surprisingly hard work lying around trying to heal. I have a set of simple physical therapy exercises (such as toe wiggling and leg lifts) to do every hour, and the cryo-cuff inside my boot is supposed to be drained and refilled with ice water every 20 minutes to minimize pain and swelling. I’m supposed to keep my leg elevated and not put it down for more than 10 minutes at a time, and I take various pills (painkillers, antibiotics, and anti-nausea meds) five times a day. It’s quite the elaborate routine but is the best excuse ever to hijack the living room TV and watch “Dance Moms” with no complaints, even from my husband and dad. 

Flowers and chocolates from my in-laws in Minnesota!

Hello from the recovery room!

I had a tough first night because it turns out that sleeping in a giant boot with your foot elevated is not the easiest task, especially once the nerve block from surgery starts to wear off and the pain sets in. Still, I managed to get a few hours of sleep, and am feeling OK now that I’ve had a couple rounds of painkillers this morning and am back in the cryo-cuff. Lots of couch time and relaxing ahead today! Thanks to everyone who has been checking in on me and sending prayers and positive thoughts!

T Minus 3 Days

So, this little surgery I’m having on Tuesday. It’s no big thing. No metal rods or artificial joints, no tube down my throat, no overnight hospital stay — just a quick surgery to pluck out a pesky, non-essential bone and clean up an angry tendon. I’m probably making too big a deal out of it. But considering it’s my first surgery (wisdom teeth don’t count; that’s just a rite of passage…) and will require significant changes to my lifestyle for at least a month, it’s a little nerve-wracking.

The surgery is supposed to take half an hour — incredible that they can fix the cause of nearly 2 years of pain in 30 minutes! Dr. Porter told me there is a 1-2% chance my ankle will be worse afterward, 12-15% chance of no change (still having pain and stiffness, but this time from scar tissue), and 82-85% chance of positive change. I'll do everything I can to be a rock-star patient and hopefully have a great outcome from the surgery.

I’ll be out of work for a week, on crutches for 1-2 weeks (no driving during that time), and wearing a boot until 4 weeks after surgery. At that point, if everything’s going well, I’ll switch out the boot for a sexy lace-up ankle brace for another month or two. I’ll see a physical therapist at Methodist Sports Medicine at every follow-up appointment, then have sets of exercises to do on my own at home. One of the best parts of this whole scenario: They’re assigning me to a PT who used to be a professional ballet dancer! It’s so reassuring to know I’ll be working with someone who gets both the physical and the psychological aspects of being a dancer and recovering from an injury (or, in my case, an instance of genetic freakishness).

If everything goes according to plan, I'll be able to head back to my favorite barre 4 weeks after surgery, then incrementally add center work, jumping, and pointe after that. My surgeon estimates it'll be 3-4 months before I can resume my full dance schedule.

Right now, I’m trying not to stress or think about it too much and just enjoy my last fully mobile weekend for a while! Thanks for all of the prayers, positive vibes, and support…they mean a lot as I'm heading into what I know will be a tough time. But in the immortal words of the Indigo Girls, "the prize is always worth the rocky ride."

Funny Bone

Hello again! It’s been a busy last week before surgery — finishing up work (plus freelance work), enjoying my final few ballet classes of the summer, making a gazillion calls to my insurance company (America’s favorite pastime…), and visiting with my in-laws who were in town from Minnesota.

I can’t believe I’m less than five days away from surgery, but before I get ahead of myself, I need to finish the story of how I got to this point!

By this spring, I was not only frustrated with the issues I was having in ballet, but dealing with pain in my “normal” life too. I decided I was way too young to be turning down walks with my husband and dog because of joint pain, and that this problem wasn’t going to disappear on its own.

I have to hand it to a friend who’s an athletic trainer — he’s the one who first posed the possibility of an os trigonum to me. (If you’re just tuning in now, read my last post for more info on this funny-sounding thinger.) I dismissed the idea at first because I’d had x-rays, and the doctor said they were normal. But when I did some research, I realized that the symptoms sounded just like what I was experiencing. I made an appointment with a different orthopedic surgeon, who took another set of x-rays …and sure enough, when the side view of my ankle popped up on the computer screen in the exam room, there it was: a “fairly large os trigonum,” as the doctor said into his little recorder.

The os trigonum is the little nub sticking out above my heel bone. In case you couldn’t tell from my awesome Paint skillz with the ellipse tool.

I think it looks like a bean on the MRI! The white spots around the bone are inflammation/fluid buildup.

I’m leaving out a lot of details here on purpose, but it became apparent that the surgeon wasn’t too experienced in dealing with this issue (which, to be fair, isn’t very common). So I went back to the Interwebs, did some more research, decided I was willing to travel, and hoped the third time would be a charm.

I had to wait a month and drive several hours for my initial appointment with Dr. David Porter, an orthopedic surgeon who specializes in foot and ankle injuries and practices at Methodist Sports Medicine / The Orthopedic Specialists in Indianapolis. He treats a lot of professional and collegiate athletes (and dancers!), including the Colts. He’s known around the U.S. as a foot and ankle guru — seriously, Google him.

The first thing that happened during my appointment was this sweet X-ray of my foot on demi-pointe:

My heel bone is jammed right up against the os trigonum. No wonder it hurts!

As I pretty much expected because I’d exhausted all the other treatment options by this point, Dr. Porter said I needed surgery if I wanted to continue dancing. He showed me on the MRI that the bone is actually fractured, and he also pointed out some nodules that have formed on my FHL tendon and did a (super painful) test that confirmed I have trigger toe in addition to an os trigonum.

Non-medical-expert briefing time again! The FHL tendon runs from underneath the big toe, through the inside of the ankle, and right past the os trigonum, so FHL problems tend to coincide with the extra bone. Trigger toe basically means that the tendon is irritated and doesn’t slide smoothly through the tendon sheath like it should. Instead, my big toe goes from being straight to snapping into a hooked position and getting stuck there. Sounds pleasant, I know. It feels nice too.

While no one wants to hear that they need surgery, I feel as good about the situation as I possibly can! I’m confident in Dr. Porter and his team — he took plenty of time to answer my questions and obviously has a ton of knowledge and experience, both in treating os trigonum syndrome and in working with dancers. Although I’ll be spending many, many hours in the car and beating a well-worn path to Indianapolis over the next few months, I already know it's worth the drive. 

Next update: the gory details of surgery (or at least the ones they've told me)!

Tales of an Os Trigonum (Or, Why Does My Right Foot Suck?)

If you’ve read my first post and are wondering, “What the #$%^ is an os trigonum? I’ve never heard of that,” you’re not alone. I had no idea I had an extra bone hanging out in my ankle — or that it had a name — for a year and a half after it started causing problems. One of my friends asked, “An extra bone? How is that even possible?”

Here’s a quick briefing from my non-medical-expert perspective: Around 5-10% of people have an os trigonum, a small accessory bone in the back of the ankle. Most of them will never know it’s there or experience any issues because of it. The lucky few who do include ballet dancers and soccer players — athletes who repeatedly point their toes downward (and, in a dancer’s case, put weight on their foot in this position).

This is sometimes called a “nutcracker injury” because the os trigonum is crunched like a nut in a nutcracker between the ankle and heel bones, and the tissues around it become irritated and painful. Can any other dancers appreciate the irony?

(Source: foothealthfacts.org)

For me, the fun started back in the summer of 2010. I was barefoot and doing releves in the bathroom (naturally) when I noticed that my right heel wasn’t as high off the ground as my left. I didn’t feel any pain, but thought it was strange that my range of motion seemed to have changed for no reason.

That fall, when Nutcracker rehearsals started and my time on pointe increased, I began feeling a tendonitis-like pain on the inside and deep in the back of my ankle. By the time Nutcracker was over, my ankle was so stiff and sore that I could barely point and flex my foot. (How did I get through a full-length ballet like that, you ask? Stage magic, my friends. And gobs of extra-strength Tiger Balm.)

In short, over the next year and a half, this cycle continued. I saw an orthopedics/sports medicine doctor, who diagnosed posterior tibial and Achilles tendonitis, and tried the following treatments: rest (at least a month off ballet, several times), physical therapy, ice, heat, walking boot, Graston technique, two prescription anti-inflammatories, and a partridge in a pear tree.

Left foot: Not a crazy banana foot, but it'll do.

Right foot: See how high the ball of my foot is, compared to the left? For a dancer, this can make the difference between being on pointe and...not.

By this spring, I had grown frustrated at the way I continued to grow stronger in ballet and improve my technique, but only on one side. I felt confident holding long balances on pointe, doing double pirouettes and fouettes, etc. on the left, but struggled just to get to full pointe on the right. At home, I was also working with a Theraband to stretch and strengthen my feet, and my right just seemed to get “stuck” while my left kept improving. While pretty much every dancer has a better side, the difference in range of motion and stability was so pronounced that I started to realize that something more significant than tendonitis might be going on.

To be continued! (Not to be dramatic, really. Just because this post is getting a little long for a world with a 140-character attention span.)

I can't believe I started a blog.

I’m Kristen — 20-something, writing/communications/PR gal by day, ballet dancer by night and weekend. I’m also an overachiever, to the point of having 207 bones.

When I first found out I had os trigonum syndrome (a painful impingement caused by an extra bone in my ankle), I poked through dusty little corners of the Internet trying to find information on this condition that, while seemingly common among dancers, is rare among “normal” people — even athletes. (“Did you WebMD it?” a friend asked. I tried, but the search results came back empty. This may be a good thing because in true WebMD fashion, the site probably would have told me I have a freak form of ankle cancer and three days to live.) 

My research turned up plenty of medical journal articles in which I understood about 17% of the words, but very few firsthand accounts of dealing with os trigonum syndrome, having surgery, and recovering. I wanted to read real stories, told by real people, about the ups and downs and when can I ditch the boot and crutches and dance again?

The few resources I did find were tremendously helpful: I enjoyed Ballet Austin dancer Michelle Thompson’s upbeat posts about her surgery and rehab on dance blog The Winger. I also found plenty of insights on Ballet Talk for Dancers, a message board that, incidentally, also helped me find my Cinderella pointe shoes. (Lovely Freed Studio Operas, fear not. This is a temporary hiatus. I will return to you soon.)

So that brings me to this blog, which is at once an attempt to keep friends and family updated throughout my surgery and recovery and to provide information to anyone else — especially dancers — who might land here after browsing the Interwebs like I did. This is also an attempt to keep myself sane while I’m couch-bound and out of ballet. Homegirl doesn’t like sitting still.  

My surgery (more specifically, os trigonum excision and FHL tendon/trigger toe release) is scheduled for Tuesday, June 26. Until then, I’ll post some background info and explain how I got to this point. After surgery, I'll share updates on my recovery and return to ballet. If all goes according to plan, I hope this will be a short-term writing project and that I’ll be back to happy, healthy dancing soon!