Post Op Leg #2

I’m home! I had surgery on Monday, February 12th and things seem to be going a lot smoother this time around.

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DISCLAIMER: Don’t scroll to the bottom of the page if you don’t want to see photos from the surgery.

For those of you that don’t know, this surgery was a little different than the one I had on my other leg. My left popliteal artery was being compressed whenever I went into plantarflexion. Luckily, it wasn’t damaged enough to require a bypass like the right one. The artery just needed to be freed up a bit from the surrounding muscle.

It’s difficult to tell exactly what is compressing the artery from imaging alone. The only way to know exactly what’s going on is when the surgery is actually performed. When they opened me up they found that the artery ran a slightly different path than it was supposed to – more medially. Plus, it was embedded in the medial head of the gastrocnemius (calf muscle) and was being pushed up against the tibia when I would move. Basically, it was being repeatedly crushed. My doctors said it was probably only a matter of time before that artery occluded like the right one.

There are various types of popliteal artery entrapment syndrome. I was told that my anatomy was a mix between Type 1 and Type 2, but mostly looked like Type 2.

paes 4paes 3My doctors took out the piece of muscle that was overlaying the artery. Hopefully now since the artery isn’t impinged by the muscle the blood flow will return to normal, and my calf pain will go away. Fingers crossed! There’s a picture at the bottom of this post that was taken during the surgery. My doctors were nice enough to take a picture for me of my leg before they closed it up and the muscle that was removed.

The surgery lasted 2-3 hours and everything went smoothly. However, waking up from anesthesia went a little bit differently and I’m still kind of confused about what happened exactly. The first thing I remember when I was coming to was someone saying, “Laurel, you’re just waking up from surgery. Everything went fine, but you need to stop moving. You’re gonna hurt yourself.” I was completely disoriented, but after peeping my eyes open and seeing the bright lights I pieced together that I was in the OR. Someone else asked, “Laurel, what’s wrong?” to which I didn’t really have an answer besides needing to cough after having the breathing tube in. Finally, I heard, “Okay, everybody stop touching her. Just let her be. Laurel, do me a favor and take some deep breaths.” I think at that point I finally started calming down. From what? I have no idea.

I then heard the staff talking about how younger people sometimes wake up really agitated, but that they don’t see it very often because most people having surgery are older than me. It’s called emergence delirium and happens mostly to kids, but it can happen to adults as well. To my horror, they discussed how I apparently kicked someone during the whole ordeal, which I have no memory of. I am so sorry to whoever that was! So embarrassing. I really wish I knew what the whole scene looked like because I can only remember bits and pieces.

The rest of my recovery was a lot less exciting luckily. This time around I have to wear a big knee immobilizer, which is pretty annoying. I’m constantly overheating from it. It’ll help keep my leg straight, though, which is good. They put a wrap around my other leg that inflated and deflated periodically. It’s supposed to help prevent blood clots. I spent most of my time in the hospital on the vascular floor. It was fun getting to see the nurses again, many of whom remembered me.

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the knee immbolizer

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helps to prevent blood clots

The fun part about this surgery was that I got to meet another person with popliteal artery entrapment syndrome! I had found a support group on facebook for people with PAES months ago, which has been extremely helpful. Another girl and I realized that we were having surgery on the same day, both at the University of Maryland Medical Center, and with the same doctors What were the chances of that!?

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The nurses called us the twins – same surgery on the same leg with matching gowns, knee immobilizers, drains, and crutches

This surgery involved both an orthopedics and vascular surgeon working together, which meant that it took a little longer to get a surgery date that both of them were available on. My guess is that they coordinated things so that they did two PAES surgeries on the same day.

This syndrome is very rare, and I know my doctor, who does more of these surgeries than most vascular surgeons, only does a few of these surgeries a year. The fact that both of us were having the surgery on the same day was pretty cool!

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we crutched our way over to look out the window

We were messaging each other the weekend before the surgery. We also ended up being roommates in the hospital, which made things a lot more fun than last time. If the Internet didn’t exist then I wouldn’t know anybody else that has PAES. It was so nice getting to talk to someone else that really “got it” and knew what I was going through.

I’m back home now and things are going smoothly. No blood clots, so I don’t have to be on blood thinners. At the moment, most of the pain is coming from my back, not my leg. Trying to find a comfortable position at night is extremely difficult. The knee immobilizer keeps my legs straight, and my back is NOT happy about that. I’m not used to sleeping with my legs straight! The incision is healing nicely. Fingers crossed everything keeps going smoothly!

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the muscle that was taken out during the surgery (part of the medial head of the gastrocnemius)

Gearing up for Surgery #2

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my favorite park to walk at

Surgery on my left leg really snuck up on me. February 12th seemed like such a long ways away, but now it’s in just a week! I’m looking forward to just getting it all behind me and moving on with my life. It feels like I’ve been in limbo this past year. I’ve had to put my life on pause to deal with my medical problems. The past few months have just been full of medical appointments, making various calls to health care providers, and recovering from surgery. I need to be done with all this medical stuff and get my life back.

My nerves are definitely worse this time around compared to my last surgery. I think it’s better to be naïve and not know what to expect. This time I remember how much pain I was in after the first surgery, I remember feeling nauseous for days from the pain meds, and I remember all the complications I had to deal with afterward. The good news is that I learned some ways from my first surgery to make this time easier.

1. No Dilaudid because I’m apparently allergic. I would really rather not be up all night scratching my body because I was so itchy like last time.

2. I need a different tape than the one they used in the OR for the first surgery. I ended up with big red welts on my chin and forehead that lasted about a week.

Luckily, this surgery isn’t supposed to be as intense as my last one. I’ll be having a muscle release instead of a bypass because my left popliteal artery isn’t ruined yet. They’ll basically free up the artery by shaving away some of the muscle that’s compressing it. In all honestly it sounds more barbaric than the bypass surgery, but my surgeon said the recovery will be a little easier. Hopefully I won’t have to stay in the hospital for quite as long and the surgery itself should be shorter. Last time my mom said I was back there for 7 hours!

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The scar on my right leg has healed up pretty nicely.

I’ve been making progress with my right leg recovery. I went for my first run since surgery on January 5th! It felt a little awkward running, which is probably because I literally hadn’t run in a year. Plus, when I used to run it was almost never on a treadmill, so I felt a little uncoordinated. With that being said, it’s amazing to be back to doing what I love most. I begged my physical therapist to let me run before the next surgery even if it was just for a minute. I just wanted to know that I could still do it.

The other day I was trying to remember what my last run had been before surgery, and I reasoned that it had to be when I had the compartment testing last January. That was definitely not a pleasant run. First they measure the pressures in the four compartments of the lower leg with a giant needle. They somehow managed to hit a nerve during the process, which is one of the most painful things I’ve ever experienced. I involuntarily jerked my leg and let out a scream. After that I ran on the treadmill until my calf felt like it was on fire and my foot was completely numb. Then they get to measure the compartment pressures again. So in comparison, my first run since surgery was 100x better than the run when I had the compartment testing!

It’s pretty slow going with the recovery. I’ve only managed to get up to 15 minutes with 3-minute run intervals, followed by a 1-minute walk interval every other day. I have to keep reminding myself that I had major surgery, and it’s not going to be as easy as recovering from compartment syndrome surgery. Plus, there were definitely some complications after this surgery, which slowed things down. Luckily, I’m enjoying doing other activities like biking and hiking. I’m also working on strengthening my core and my right leg, which will be doing most of the weight bearing after this next surgery.

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me, Ned, and Samson have loved getting some hikes in

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Sam somehow grew an icicle beard on our walk

I’m not sure if I’ll be posting again before the surgery. If not, I’ll see you on the other side! Fingers crossed everything goes smoothly.