Saturday, April 2, 2011

Fasciotomy Pre-Op Appointment - Cautiously Optimistic



Finally it came to the day I was looking forward to for a couple weeks. When I got called at the office, a fellow who works with the surgeon came in to take my history, and ask if there were any problems, etc. I explained to him that over the last couple weeks I had started to feel the effects of CS even when I was not exercising, as it manifested itself in a sort of uncomfortable, not getting great circulation feeling in my legs. He explained that this was not crazy, and sometimes is how compartment syndrome progresses.

Then the surgeon came in. He explained to me that even though I had only three compartments test positive for compartment syndrome, he thought it would be best to release all 4 on each leg. I asked him the reasoning for this, and he explained his reasoning: 1. I had explained to him that most of the pain I felt during running was actually in the lateral area, and thus he thought it would be foolish to leave the compartment alone and 2. He told me that there have been lots of cases where people get 1,2, or 3 compartments released and then are symptomatic later on for the fourth and have to have surgery all over again, so it was safer to release all 4 compartments in this case.

I was worried, however, that this would make the procedure a little more risky, just from the logic that the more compartments you mess around with, the more random things can go wrong. He responded that the releasing of the lateral compartment did not significantly compromise the success of the surgery, and that the benefits of doing so far outweighed the risks.

Then, on to success rates. The doctor told me that 90% of his patients experience full recovery, meaning they are able to achieve athletic performance levels that are commensurate with how their performance levels were pre-onset of exertional compartment syndrome. While in the grand scheme of things, that is not as high as I would like, after reading the literature and looking at online forums, it unfortunately seems that that is the best you are going to get. Plus, I would like to think that since I am still relatively young, my chances will be good.

In terms of a recovery timetable, my surgeon said at 4-6 weeks I could begin to do cycling, 6-8, running, and at about 10-12, I should be nearing full recovery. While that is a substantial amount of time, I really don't care in the slightest if I will finally be able to do the things I love for the first time in a long while.

The surgeon also said he would be sending me for an MRI just to rule out vascular restriction in my legs, as apparently that sometimes causes compartment syndrome-like symptoms. With that, I thanked him profusely, and barring a rare case of vascular restriction, was set to go under the knife!

6 comments:

  1. hi Sam,

    My name's Tom, I'm 21 and live in the UK. More importantly, I'm 7 weeks, two days post-surgery, where I had all four compartments released in both legs.

    I first started developing lower leg pain over two and a half years ago, when I started increasing my running mileage too fast, too soon in response to my decision to join the Armed Forces once graduating from University. Countless osteopaths diagnosed me with 'shin splints' and prescribed conservative methods of treatment.

    To cut a long, frustrating story short, I tried all sorts of treatment, biomechanical tweaks and rest, but if anything my symptoms just got worse and spread to other parts (for the first twelve months it was just deep posterior, but soon spread with a vengeance to tibialis anterior).

    I spent one night in hospital on 11 February, had my staples taken out on day 10 and started doing small amounts of exercise from then, which primarily was increasing the amount I was walking and starting on the bike. I had a surgical follow up at week 3, where the surgeon gave me the green light to start running but I definitely wasn't confident enough to do so at the time, so I waited until week 4 and a half until I did my first jog.

    I'm currently able to do a run every 3/4 days, which usually consists of walk/run interval training. I've built up to a 30mins session (10mins walking / 20mins running) on flat grass. I definitely wouldn't say I'm completely recovered - legs are still very sore at times and if I'm on my feet all day I still get swelling. I reckon another 4/5 weeks until I'm back to normal.

    Best of luck with your recovery - I'll try and chip in and comment on your blog if I feel I can offer anything useful.

    Tom.

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  2. Hey Tom, thanks so much for providing your experience with the whole process! I was wondering if you have any more tips that you have learned over the entire recovery period? When did you start physical therapy? Was there a certain exercise that you felt really helped you along? Did you experience any setbacks (such as numbness?) - Anything you could add would really benefit all of those unfortunate enough to be afflicted with this terrible condition!

    Thanks and I hope you continue to progress!
    Sam

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  3. i had this surgery in my right leg, i was off of my crutches within 12 days and began therapy 9 days after

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  4. addition to above post: my surgery was on April 20th 2011 and I am walking fine now, still working on full range of motion bending wise, but going well

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  5. be careful, I had surgery on both legs (all 4 compartments in each leg). This was 2 year ago. never walked on my own 4 a year and still can only manover on flat surfaces. Pain level stays near a 5 90% of the time. Pray yours is a success but don't go into this without knowing the possibilities of surgery gone bad. Find u an excellent surgeon and one that is fully familiar with this surgery and its consequences.

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  6. just had the surgery a week ago. left the hospital and could walk ok, but not my heels can't both touch the ground. did that happen with any of you? thanks

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