Measurable Progress

Ok - I have measurable progress!  The chart on the left shows each of my runs (1 dot = 1 run, size of the dot = length of the run).  It's Heartrate/speed on the Y axis, and date on the X axis.  Lower is better - i.e. your heartrate is lower for a given speed, or you can run faster for a given heartrate.

The blue rectangle on the left is pre-surgery, post marathon, when I was fit.  At my fittest I was running high 17's for HR/speed.  The purple box in the middle is when I decided to get a little back into shape pre surgery.  You can see how quickly progress is made.

The red circle shows my first tentative post-surgery runs; they were all 1-2 miles and pretty slow (9ish pace).

The last 5 runs I have started to stretch things out a little. I'm up to 4 miles and running around 8 minute pace.  The data shows a nice little cluster right around 20.

Looking back over my training log I can see that I can get from >20 to under 18 pretty easily in about 3 months, so I'll just follow a similar plan to that time.

Spoke to my doctor today, and he is encouraged by the progress and lack of pain at the injury site.  He was also happy (and a little surprised I think) that I have kept it slow and only gradually increased miles.  I have some tightness in the inner thigh muscles, but he wasn't worried about that.  He wants another 3 weeks of running first.  Although it's only 5 weeks since surgery he was fairly confident that I should make a 100% recovery.  I see him again on December 17th.

Plus, had my first rainy run today - it was good to get out in the rain and mud again.  It was also my first time running two days in a row since early August.  So fingers crossed, it's all looking good.

Still Going

Things continue to progress, albeit fairly slowly.  I'm running every 2-3 days and am now up to 3.5 miles!  Still pretty slow stuff, although I did manage to dip under 8 minute pace the other day for a mile or so - and nothing burst out of my abdomen like something from Alien.  Surgery seems to be healing well, fitness is still noticeably absent, but I don't expect that to really change while only running 5-10 easy miles per week.

I'm going to try 4-5 runs this week, which will mean some two-days-in-a-row runs.  We'll see how that goes, but if there are no issues I'll try for 5-6 days next week, and then 6-7 the week after.  I am tentatively planning to try some strides (100 metre runs at a "fast" pace) on the 10th, which will be 7 weeks after surgery. 

Then I revisit the doc on the 17th, when he will hopefully declare me "cured" and I can start working on the next injury.

Slow, Steady Progress

This whole, common sense and patience thing is really no fun.  I've now run 4 times, or every other day since last Friday.  I hit a long of 2.3 miles yesterday, at a blistering 8:42 pace.  It's weird to get ready to run, go out and then be back home within 15-20 minutes.  I'm used to going out for 2+ hours.

But things seem to be progressing well.  No pain from running, which is really all I'm asking at this point.  I'll keep the every other day schedule for a while and keep slowly building up the mileage. If I'm up to 5 miles most days by the first week of December I'll be happy.

The road back...

I saw Dr. Brown today for my post surgery followup.  He went through the surgery pictures with me and showed me what he did.  It turns out that I'd only ripped the first two layers of muscle on each side, not all three.

Overall he was happy with the recovery although the bruising was worse than normal.  The good news is that he OK'd me to start some easy running. Nothing fast, and nothing far.  Just an easy 8-10 minute mile.  He said that if it hurts I should stop.  If I need to sit on the couch and recover for an hour afterwards I need to take a day off.  If it's OK then I can slowly increase the distance and see how it goes.  I need to let common sense be my guide, which may be a problem.....

So I went out and ran late this afternoon.  Just an easy mile and a bit round the neighborhood.  I didn't have any pain in the surgery area and it felt far more comfortable than my last pre-surgery run.  So it looks like it has been successful.

Fitness is a completely different matter.  I am pretty out of shape.  One of the key metrics I use is to look at my average heartrate for a run, divided by my average speed (miles per hour).  As fitness increases this decreases.  Obviously longer runs, and hilly runs can skew the data but I find it a reasonable measure of fitness when trended over time.  Here's a chart that shows how it has been since early August (when I was in the best shape of my life).

To explain the numbers consider a 10k race (6.2 miles).  If I run one of these I can pretty much expect my average heartrate to be about 170-172.  If my fitness (HR/speed) is at it's pre-surgery peak of 18 my speed would be 9.55 mph, which is 6:17 mins/mile, so 39:03 for a 10k. That's the kind of shape I was in (although I never actually ran a 10k that fast...).  At my post surgery fitness level of 21 that same 10k would be at 8.2 mph, which is 7:20 mins/mile, or 45:34 for the 10k.  So I have my work cut out to get back up to speed!

The plan is to run 3 days and then add 1/2 mile to the distance.  All slow miles in the 8-10 min/mile range.  That will be the routine for the next 4 weeks.  If that goes well I will be up to 5 miles by my birthday (November 29th), which will be about 6 weeks post surgery.

If that goes well, I can start thinking about adding in some faster and longer stuff. 

2 Weeks Done

It's been 2 weeks since the surgery, so 1 more week of walking before I can start "jogging and gentle running in straight lines".  I'm still not sure exactly what that means....is it 100 yards at 12 min pace or is that 10 miles at 8 min pace?  I am seeing my Doctor on Firday for a post-surgery checkup so will get his input.

Swelling has pretty much subsided, bruising is still there but beginning to change from black to red/yellow.  I guess another couple weeks before that is fully gone.  No ibuprofen for the last 5 days so I'm officially through the painful phase.  Walking is pain free (depending on what I'm wearing) and sleeping is no longer uncomfortable.

So overall it's been good progress this last week.

Major milestones!

Just sneezed and it didn't hurt! This may not sound like much but I sneezed Monday and it made my eyes water. Plus, this without any ibuprofen. Also last night was the first time I could sleep on my side.

So things are looking good. Before too long I'll be back out running - ready to break something else.

Recovery So Far

It's been five days since surgery and things are going well.

• Wednesday (surgery day) was pretty easy as all I did was sit on my butt and I was still pumped full of drugs from the hosiptal. 
  
• Thursday went OK. I didn't take any hardcore pain killers, just 4 ibuprofen every 6 hours.  Walked round the block 3 times, albeit slowly and a little hunched over.
• Friday was pretty much like Thursday, but I was walking like a 60 year old vs an 80 year old.
• Saturday I went down to 2 ibuprofen every 8 hours and walked for about 2 miles total.
• Sunday was just 2 ibuprofen at 9am and 2 before bed.  Walking up to 3 miles, with a reasonably normal stride.
• Today I'm back at work and feel pretty normal.  Still definitely slow and I get athe occasional sharp pain, especially when I move after sitting for a while, but overall it's going really well.

Swelling is down, but the bruising is out of control.  Everything (and I mean everything) from the stitches down is black.  Doesn't hurt at all but looks really freakish (sorry, no pictures of that are coming!).  Apparently it's pretty common after hernia surgery and goes away in a couple weeks.

Next 2 weeks are all easy stuff.  Just walking 3-4 times/day, and I can start some gentle stretching.  I need to go have a followup exam just to check that it's all looking OK, will probably do that early next week.

The details

Time for a surgery recap for those of you that like that kind of thing......  It is a reasonably simple surgery since it doesn't involve cutting through or near any major organs, muscles etc.  Because I had a bilateral hernia (both sides) he recommended general anaesthesia VS local with sedation.  He's the expert so that's what I did.  Went under about 9:30am and came round in recovery about 11.  He took pictures for me, and this is apparently what happend during those lost 90 minutes.

First shot is the left side after the initial opening.  The cut is about 1 1/2 inches to give you some idea of scale.  The stuff outlined in green is my insides and really shouldn't be visible!  There are two layers of muscle wall that I've torn through to do that.

Next shot shows the stitching for the lower layer.  This should keep the inside bits inside, where they belong.  He prefers to do this type of open surgery with real sutures instead of going laproscopic and using mesh.  Sutures are more effective in guarenteeing things are closed and you don't have to deal with any potential side effects of having mesh inside you.  Also, as you are open he can see exactly where the issue is and remove anything else that shouldn't be these.  In my case I had a lipoma (buildup of fatty tissue) on each side which he took out.  These occur about 50% of the time with hernias and are another cause of pain, so I'm glad they are gone.

This one shows the final stitches in the top flap of muscle wall.  That bit at the bottom of the picture, held out of the way by the yellow/white strap is my spermatic cord (sounds important to me).  They pull that out to avoid cutting it by accident!

This one is the left side all stitched up - final scar is just over 1 inch long.

The right side was pretty much the same, here's a picture that shows the right lipoma!  This was over an inch long and couldn't have been helping me all that much.  The body is definitely a weird thing.

Recovery is going well.  There is swelling, which is going down a little, and plenty of bruising.  I have a percocet prescription but so far have just been taking ibuprofen.  Doctor is surprised that I am not needing anything stronger but says that it's fine if I'm OK with it.  I really don't want to be completely drugged out on painkillers, so will try to keep going with just the vitamin I.  Right now it feels like a dull ache, which to be honest is how most of my long runs felt for the last few months.  I'm meant to do a little walking if I feel up to it, so will be doing a few laps of the block today.

So it looks it's all been successful, and I am on track for a reasonably manageable recovery period.  Gonna spend today/tomorrow at home but back to work Monday.

All done

So it's all done. It went smoothly and I was out of the hospital by 12:15. Doesn't feel too bad, just an ache like I've been kicked in the goolies. Of course, I am still full of drugs from the surgery so we'll see how I feel when that wears off.

Doctor gave me a DVD with pictures so I'll post some tomorrow so that inquiring minds can see for themselves.

Probably not going to run this afternoon......

45 minutes.....

At the hospital, all checked in, should be going to the prep room in about 10 minutes.

All Set

Only 18 hours to go! Surgery is at 9:30 tomorrow morning.  It's usually about 40 minutes, but presumably will take a little longer since I have managed to mess myself up so well.  Should be out of the hospital by about 2 if all goes according to plan.

I am ready with my prescribed percocet but am quietly hoping that I can get by using ibuprofen.  I guess I'll find out sometime tomorrow evening when the anaesthetic wears off and the pain starts.

This is what it should look like in there.  The doctor needs to join these two bits back together.  In my case this is on both sides, plus I've managed to get through the next couple layers too, so bits of me are poking out.  He has to put all that back inside first.  Seems quite messy but I'm sure he knows where it's all supposed to go!

Weight hit a new high today at 154.0.  Up 10.6 pounds from my low in July.  I've almost plateau'd since starting to run 3 times a week, but I expect to start picking up again post surgery.  Looks like I need to eat (or maybe drink) a little less.

Countdown!

So I finally saw Dr. William Brown this morning, and he confirmed that not only do I have a bilateral sports hernia (tear in the top layer of the abdominal wall/oblique muscles) but I have also managed to tear through the next two layers to add a couple of regular inguinal hernias. (I guess running 430 miles in July wasn't quite such a good idea after all....).  These are the ones where your intestines start to poke out through the holes in your muscles. Pretty good stuff eh?

Good news is that he can fix it all the same way at the same time and it doesn't really make the recovery any more involved.

I'm set for surgery next Wednesday morning.  He recommends doing it under general since it's a bilateral, but there is the option for local plus sedation if I want.  He already prescribed me some percocet for the post op days.  

He gets almost all his patients back to their sport by about 9 weeks, with 95% of them pain free. The other 5% have some slight residual pain but not enough to deter them from competing.  Other good news is that out of the 300 he has done, he has only had 3 reoccurrences, which is encouraging.

The days after the surgery aren't meant to be too much fun, and he said I probably wouldn't feel too much like driving to work and being nice to people for a week or so.  Funny, I don't feel like driving to work to be nice to people most days anyway.

The 9 week rehab plan will take me to December 24th, so if all goes well, I will be good as new on Christmas Day!