8 Weeks Post Op

CT Scan Results: The graft is working beautifully! I saw the scan and it was really interesting. You can see exactly where my popliteal artery becomes blocked and the blood stops flowing. Then you can see the vein graft going around the blocked portion of the artery and it is wide open and working great.

I also had a repeat ultrasound done since the wound is basically all healed up and they could actually look at the popliteal vein. Luckily, it showed that there are no visible blood clots. Woooohoooo!!!!! That means I can also get off Xarelto (blood thinner) and just switch to aspirin now. I still have to wear compression socks, though, which is a pain. At least I’m pretty used to them at this point.

The incision that opened back up is basically closed again. It’s pretty amazing how quickly that healed. When it first opened up it measured 4cm deep into my leg! It’s just scabbed over at the top now. The scar now reminds me kind of a half smile. I had a little fun with making some artwork out of it. I had to figure out some way to laugh at the situation. Yes, I already know I’m weird.

I got cleared to drive again, which has been fantastic. I never realized how much I like being able to drive myself around until I couldn’t do it. The best part is that it doesn’t hurt to drive anymore. My calf used to cramp up when I’d press on the gas/break, which made driving kind of a miserable experience. Now I’ve gone for a 30+ minute drive and my leg felt completely fine. It’s nice to also have some solid proof that the surgery really did work.

I’m now able to walk without a limp. My leg still feels stiff after I’ve been lying down or sitting with my legs bent, but loosens up pretty quickly now. I’ve been able to walk quite a bit and get back over to my favorite trails and bike paths, which has felt great. I’ve been told that I’m walking a lot faster than I did pre-surgery. I can now walk up hills and walk at a decent pace without my calf cramping.

I think my dog, Samson, is excited that I’m more mobile too because it means we can spend more time at the park. I’m an outdoor person at heart, so having to be housebound has been really difficult. Just getting outside and feeling the sunshine always makes me feel better.

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5.5 Weeks Post Op

The recovery keeps moving along. I guess this time more smoothly than it has been. The wound that opened back up is now almost closed. It’s pretty amazing how quickly that healed up. Originally, the wound was about 4cm deep and is now probably less than 1cm. I still can’t quite picture what it’s going to look like once it completely heals up. The edges need to come together more. I really hope I’m not left with a giant ugly scar. The scar after surgery looked so neat and thin before it reopened. Luckily, my scars fade pretty nicely. The scars from my compartment syndrome surgery are now barely noticeable. Unless someone is seriously inspecting my legs they really don’t notice.

I’m now able to walk without crutches (for the second time). I still need to work on regaining my full range of motion, but I’m definitely seeing a lot of progress. I’ll be starting home PT soon, which apparently I can get because I’m still having a visiting nurse help with my wound care. The wound has now healed enough that I only need a new dressing every other day instead of every day. Yay!

I’ve been feeling a lot less tired than I was. I think the anemia has improved even though I don’t have any test results to show that. I don’t feel lightheaded as easily and I have more energy. I guess I’m feeling less like a zombie compared to how I was a few weeks ago.

I had a CT angiogram yesterday, which will look at the arteries in my leg to see if the graft is holding up. My worry is that the hematoma that formed after surgery might have impacted the graft. It was a pretty significant hematoma; 3x4x10cm. My doctor also said that depending on the results of the angiogram I might be able to get off the blood thinners. I really hope so because I am so over these blood thinners! They’ve made my already dry skin even drier, and I’m sick of bleeding everywhere.

Now is just the hard part of waiting for the results of the angiogram. My guess is I won’t hear anything until next week because of Thanksgiving and all. I have an appointment next Wednesday, so at the latest I’ll hear then. Who knows, maybe the wound will be all healed up by then?

I always find waiting to be the hardest part of this whole process. I’d take physical pain any day over the anxiety I’m feeling right now. Luckily, there’s a holiday tomorrow with lots of good food and family to provide a distraction. Happy Thanksgiving everyone!

4 Weeks Post Op

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“You got this.” I’ve been telling myself this every day of the recovery.

Slow and steady is the name of the game. The reopened incision is slowly healing and will just be a matter of time. I found out that the reason the wound reopened was definitely due to bleeding. Since I had a blood clot after surgery I was put on blood thinners, which meant that my blood couldn’t clot as well as normal. I ended up with a hematoma (bleeding) in the wound. This was evidenced by an MRI I had a week ago. Over time it built up so much pressure that the incision opened back up.

The blood thinners have been a bit like a double-edged sword for me. Now, obviously blood thinners were necessary because of the blood clot. Left untreated, blood clots can potentially be fatal. However, the blood thinners also caused a hematoma to form, which then reopened the incision and has delayed the healing process by quite a bit. I sure hope I don’t get a DVT during the next surgery and need to be on blood thinners again. I’m getting pretty sick of compression socks and accidentally bleeding on everything.

It also makes me wonder if there’s something about me that makes me prone to hematomas. I’ve only had 2 surgeries and both times I developed a hematoma. Come on! The second time makes sense because of the blood thinners, but not the first.

My main complaint this week actually hasn’t been about the wound, though. I’ve been more bothered by how low my energy level is. At the ER I found out that I’m anemic. I’m so tired that I feel like I could sleep all day and still not be rested. I also get out of breath so easily it’s ridiculous. Plus, my already pale complexion looks even paler if that’s possible. I’ve never been anemic before, and I’m really not liking this. I’ve been a vegetarian for the majority of my life and have been proud that my iron levels have always been fine. I’ve even donated blood before. I guess it makes sense that I’m anemic now given how much blood I’ve been losing. I’m working hard at eating iron-rich foods and a multivitamin with iron, so hopefully I’ll feel better soon.

Good news! I had an ultrasound done on my leg to look at the veins this week and check on how the blood clot is. They found no visible blood clots in the veins in my legs! Yay! Of course they couldn’t see all of the popliteal vein because of the open wound that was bandaged up, but above and below look good as well as all of the rest of the veins in my legs. At first I thought the blood clot was just in my popliteal vein, but when I looked back over my medical record it actually said there were small clots in the popliteal, posterior tibial, fibular, and gastrocnemius veins. I’m beyond grateful that they don’t see any blood clots there anymore. I was expecting it to take a lot longer! Maybe this means I won’t have to wait a really long time to have surgery on my other leg.

Anyone have any good TV show series that they would recommend? I’m running out of ideas of what to watch on Netflix and Hulu. Thanks!

3 Weeks Post Op

I had originally started a post last week just updating that my recovery was going smoothly and that I kept improving. I had gotten to the point where I could walk without crutches for short periods and had even gone on a stationary bike (very slowly) for a couple minutes. The incision looked like it kept healing nicely.

Unfortunately, that status changed last week. Saturday night when my mom went to go change the dressing she noticed that a small part of the incision looked like it was spreading apart slightly. Naively, we redressed it and decided to go get some steri-strips in the morning thinking that would be enough. Let’s just say that when we went to redress it in the morning the incision had not stay closed. I will not be sharing pictures, but I’m sure you can guess what it looks like.

After a trip to the ER we’ve got things sorted out. I guess the theory as to why it reopened is mainly due to the blood thinners I’m taking for the DVT. Apparently there was a lot of bleeding into the wound, which created swelling and pressure, and therefore reopened the wound. I’m counting down the days until I can stop the blood thinners, but I’ve still got a few more weeks. I’m sure it doesn’t help that the incision is on a joint, so it’s being stretched whenever I move. The incisions up by my groin where they got the vein for the bypass is healing quite nicely. Again, this is probably because it’s not on a joint.

I don’t think we have all the answers as to why the incision reopened. Whatever the reason, I’m still on the road to recovery, but just with a bit of a setback. I was told it will take 3-4 weeks to heal up. The wound has to heal from the inside out. If a few stitches were just put to hold the skin together then that wouldn’t be good because the inside isn’t healed.

A visiting nurse comes every day and cleans it and redresses it, which is not a fun process. It’s not that it feels really painful, just extremely weird and uncomfortable. It also doesn’t help that I know they’re literally in the middle of my leg. I find myself starting to freak out if I think too much about what’s going on. I can’t believe there’s literally an open wound on the back of my leg. The good news is that it’s not infected. Everyone keeps telling me that it looks clean, which is great. I’m on some antibiotics just as a preventative measure. I also have youth on my side. I’ve been told multiple times that I’m going to heal much quicker from this than someone just 10 years older than me.

Yes, this is a bit of a setback. However, I’m thankful that I can already tell some improvement in my right leg after surgery. Just at rest I can visibly see that my right foot is now pinker than my left foot. What used to be my “bad” leg is now my “good leg” and vice versa. Even with this complication from the wound and a DVT in the popliteal vein the circulation has already improved. For that, I am beyond grateful! That means more to me than anything. Check out the pictures below comparing pre-op to post-op.

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PRE-OP

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POST-SURGERY: My right foot is now pinker than my left! Yay for Circulation!!!!!

Post Surgery

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My dog was happy to see us home again.

I’m finally back home from surgery and I’m doing pretty good. Overall, the operation went really well. I ended up staying in the hospital from Friday and got out Tuesday midday. Disclaimer: if you have a weak stomach, then don’t scroll to the bottom to see post op photos.

The operation was definitely a lot more involved than the surgery I had for compartment syndrome and lasted quite a bit longer. Luckily, the surgeon said that the vein they used for the bypass looked great, so hopefully that’ll hold up well over time.

The first night after surgery was pretty rough. My leg kept cramping up. I was on some pain meds including a pump I could use to administer pain medication when I needed it. The only problem was that I was so tired that I would fall asleep and then wake up in excruciating pain because I hadn’t been pressing the button. Then it’s hard to get caught up with pain management. Plus, I guess I had a reaction to the Dilaudid because I could not stop itching – mostly my face, but also my arms and neck. It was pretty strange.

I also found out that I have a DVT (blood clot) in my right popliteal vein. My doctor said he’d be surprised if I didn’t have a DVT. Apparently, they needed to do a lot of manipulation of my vein during surgery. So, that just means I’m taking blood thinners and wearing compression socks. The theory is that as long as I’m on blood thinners, the clot won’t get any worse, and over time will be broken down. Unfortunately, that means the surgery for my left leg will be delayed a bit because I can’t have surgery while still on blood thinners. Hopefully, a repeat ultrasound in a few months will show the clot is gone.

I got up out of bed the day after surgery. It’s pretty painful, but manageable. Bending and straightening it out hurts since the wound is right on a joint. I’ve just been elevating my leg a lot, icing, and working on my range of motion. Netflix and Hulu are helpful too.

Around the second day post op I started feeling nauseated. I was hoping I could tolerate the pain meds better after getting sick from the Percocet after my last surgery. I guess my body really can’t take narcotics, though. I ended up just switching to Tylenol, which has made things manageable. I’d rather be in some pain and not be nauseous than be pain-free and puking. That’s just me, though.

I was discharged on Tuesday and we made it back home on Wednesday. I started physical therapy today and am so glad to be on the road to recovery. I’d take ANY day of post op pain/nausea over the emotional pain the past 10 months have been. I have hated waiting for appointments, waiting for referrals, waiting for test results, and feeling like I was getting nowhere. I can take the painful compartment testing, but I can’t stand feeling lost. I’m just so glad to be headed in the right direction.

I received excellent medical care while at the University of Maryland. The doctors, nurses, PT’s, etc. were all fantastic. I can’t say enough good things about the care I got. I would highly suggest going to the University of Maryland for the treatment of popliteal artery entrapment syndrome.

The pictures below show the scars from surgery. They look pretty bruised up because of the blood thinners, but that’s normal.

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My leg 2 days post op

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the scar on my upper thigh where they harvested the vein to use for the bypass

The blood thinners made me bruise pretty badly from the IV’s.

Popliteal Artery Entrapment Syndrome

Hey blogging world! Long time no see. I’ve decided to start blogging again to document what’s going on in my life right now. You see, this past year has been absolute hell to put it nicely. I’ve gone from being a marathoner to not being able to walk without pain.

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My feet after walking less than a mile. My right foot loses color and turns a pale white.

I was diagnosed with bilateral popliteal artery entrapment syndrome. I know, it’s a long name. Basically, this means that one of the muscles behind my knee is attached abnormally and is crushing my popliteal artery (the main artery behind the knee). My right popliteal artery is completely blocked and requires bypass surgery and my left popliteal artery is partially blocked when I push off with my foot. Popliteal artery entrapment syndrome is a rare problem that normally occurs in young athletes.

It’s been a very long journey getting to this point. I first noticed symptoms last December, although I now realize that I had symptoms long before that. In the matter of about a week, I went from half marathon training to not being able to run for longer than 100 meters because my right calf would cramp so badly. I’m not talking about a little bit of aching. I’m talking about the feeling of trying to run with a Charlie horse. Within a matter of minutes of stopping, though, the pain would completely disappear.

At first, I thought that it was compartment syndrome again, but after repeating that fun test my pressures were normal. There were some other pretty weird symptoms going on too. My big toe is numb and sometimes I get weird tingling sensations in my foot and lower leg. Probably the weirdest one, though, was what happens when I walk. My foot loses color and starts turning a pale white. It’s pretty creepy.

I tried getting a deep tissue massage, didn’t work. I tried physical therapy, didn’t work. MRI didn’t show anything wrong. Then I was referred on to a vascular doctor and a whole new round of tests was done. Ultrasound, treadmill test, an MRA, and finally an arteriogram was done.

All the while my symptoms have been getting worse and worse. It’s now at the point where it hurts just walking. Standing for long periods of time is also painful. Even pushing down on the gas pedal when I’m driving causes my calf to cramp.

Hearing the diagnosis was absolutely shocking. The worst I was expecting was that I had compartment syndrome again and needed another fasciotomy. Instead, I found out that not only do I have popliteal artery entrapment syndrome in my right leg, but my left leg (which is relatively asymptomatic) as well. This probably explains why my right leg has never been all the way better since I had compartment syndrome. That’s probably why I couldn’t get past mile 20 in a marathon without my calf completely seizing up and why I get Raynaud’s so much worse in my right foot than my left.

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My right foot with Raynaud’s syndrome after going swimming. My left foot was a totally normal color. This picture was taken over 3 years ago.

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This is what my foot looked like after trying to do some calf raises.

I’m finally scheduled to have surgery on October 13th at the University of Maryland Medical Center. I will be having a bypass done on my right leg. Then I’ll have to wait another 2-3 months and get a muscle release done on my left leg. Even though my left leg doesn’t have many symptoms, they want to fix it earlier on to prevent needing a bypass like my right leg.

I’m looking forward to getting this surgery done so that I can get my life back. I’m a 23-year old marathoner that is in pain just walking. How wrong does that sound?! I want to get this surgery behind me and finally get on the road to recovery.

Thanks for joining me on this journey. I plan to make regular updates. I hope that sharing my story will bring a little more awareness to this weird syndrome. Maybe another “Laurel” will find this blog and be able to understand a little more of what to expect.

Back to Reality

Lake Louise

Last Friday we officially made it back home from our wonderful trip. Although it’s only been a week it feels so long ago that we were cycling the west and snuggling into our sleeping bags at night.

The last time I gave an update we were in Nanaimo. From there we continued westward on Vancouver Island to check out Tofino and then spent a few days in Victoria, where we reached 2000 miles. We took a ferry back to the US to Port Angeles, took a hike on Sunset Ridge in the Olympic National Park, camped for the last time at our very first campsite (Manchester State Park) in Port Orchard, and finally went back to Seattle to catch our flight home.

my dad skipping stones on the ocean in Tofino

my dad skipping stones on the ocean in Tofino

taken at the Butchart Gardens

taken at the Butchart Gardens

more Butchart Gardens

more Butchart Gardens

over 2000 miles!

over 2000 miles!

beautiful Victoria!

beautiful Victoria!

Sunset Ridge

Sunset Ridge

This really was a trip of a lifetime and I’m so incredibly grateful that my parents and I were able to make it happen. I’ll never be able to thank them enough for bringing me along on this trip. I’m not sure I’ve ever been as happy as I was during those six weeks. It was like we were in our own little bubble of unreality where we didn’t have to think about real world problems. I’ll definitely miss the adventure of it all, that satisfying feeling at the top of a mountain pass, not knowing exactly what the next day will bring, and cracking up with my mom while secretly taking pictures of my dad sleeping … no, Dad, I won’t post the pictures. 😉 Heck, I’ll even miss getting lost from time to time.

I’m naturally a very practical person. I do the things that are expected of me in life and rarely spend my money on things outside my necessities. However, I don’t want to live my life being boring and not experiencing the things I dream of. This trip really made me realize that we only have so much time on this earth. We’re not guaranteed the next day in life so CARPE DIEM!

What’s next for me? I’m starting my senior year of college (I know, crazy!). In terms of athletics, I’m getting back into my normal running routine. I was able to keep up some mileage when I was biking and got a lot of practice running on tired biking legs. I know I’m fit right now, but biking fitness isn’t the same as running fitness. The sports use different muscles, so I’m planning on gradually building up this fall and possibly doing a couple of shorter races in October or November. My long-term focus will be on the Boston Marathon. Registration opens up in mid-September, so hopefully I’ll get a spot with my qualifying time.

at the beginning of our journey

at the beginning of our journey