Tuesday, May 5, 2015

Life and Limbs: My Compartment Syndrome Story

My sophomore year of college is finally over. I’m at home, sitting on the couch, TV on, snacks and drink in hand. My legs are up, but that’s not just for relaxation’s sake; there just happens to be a 4-foot tube sticking out of my right leg, draining one of six incisions from my second surgery in a month.

You know, just the normal way to celebrate making it halfway through my undergraduate degree.

It’s helpful at the end of any challenging period of life to spend a little bit of time in self-reflection. Retracing the story from beginning to end, even if that end is still unclear, is therapeutic in a way. As I tell my story, I’m admitting from the beginning that I still do not understand why this story has to be part of my story. At times, I am still scared and frustrated and angry, even as I am recovering. But perhaps remembering where I’ve been and how far I’ve come will give me some extra strength to keep moving forward.

Here’s my story:

10 months ago, at the end of July 2014, I ran a 5k, a 90’s themed fun run with one of my best friends. It was a super fun day (I got to wear a floral snapback and a Teenage Mutant Ninja Turtles cutoff tank, what’s not to love?), but I struggled the entire race with pretty severe shin pain. I chalked it up to bad running form—shin splints—and kept running. Two days later, when my legs still hurt to the point where I could barely walk, I still wasn’t concerned. I figured that my new shoes or lack of running experience had caused my shin pain and laughed about never running a race again. A few more days of rest and my legs would be back to normal. I couldn’t be more wrong.

A month later, I began my sophomore preseason of volleyball at Cairn University. I was both incredibly excited and incredibly nervous for the upcoming season; I had not gotten much playing time as a freshman, yet I was voted a captain and earned a starting role for this season. I expected a lot of myself. I vowed to never be satisfied with my performance; every area of my game could always get better. Doing anything less that 100% was not an option. I’ve always been a driven athlete, but I truly believed that if I put all of my heart and hustle into this season, I had the opportunity to shine. “Heart and Hustle” became my mantra; maxing out both my physical effort and my mental stamina became the way I approached every practice and every game.

Three days into preseason, the leg pain returned. I immediately went to see my trainer and we agreed that shin splints were my problem. I started to heat and ice my legs daily, hoping that as I got more in shape, my shins would begin to fall in line. As practices went on and the school year started, my legs seemed to be getting worse, not better. Accompanying the sharp aching along the inside of my shins was a deep pain that seemed to fill up my calves and stop my muscles from working properly. Three different kinds of tape and expensive shin braces did relatively nothing to alleviate the pain. Nevertheless, I fought through the pain. I needed volleyball to give my life structure and couldn’t bear the thought of being unable to play.

I remember the moment I knew that there was something seriously wrong with my legs. It was about 8 or 9 games into our season, and we were away at a school. Our first set hadn’t gone very well and I was determined to play much better for the rest of the game. I walked out on the court before the set began and turned to speak to one of my teammates. All of a sudden, the deep, full pain that had occasionally filled my legs before came back with a vengeance. This was the first time that the debilitating pain had occurred without any physical activity to bring it on. I struggled through the rest of a disappointing match and sitting on the sidelines afterwards, head hung low and struggling through tears, I knew that I had a bigger problem than shin splints. I just didn’t know what.

Stress fractures. That was the consensus of my athletic trainer and my orthopedic doctor. Heartbroken, I had to stop playing volleyball and trade my Mizunos for a walking boot and crutches. I went through the MRI, sadly confident of the diagnosis and that I would not be playing volleyball for at least 4 weeks.

No stress fractures. The MRI came back completely clear, except for some inflammation on the tissue lining my bones. Basically, just really bad shin splints. My doctor cleared me to play volleyball, claiming that the pain and inflammation would go away as soon as the season was over and I got some rest. I finished the season in an incredible amount of pain, but I was just so relieved to be back on the court.

The season ended and I wish I could say my pain ended too. Unfortunately, my legs felt the same 2 months after the end of volleyball that they did during the season. After switching doctors, more x-rays, and a bone scan, I still had no conclusive answers. However, my one doctor had mentioned one possible answer in passing: compartment syndrome.

Exercised-induced compartment syndrome. A neuro-muscular condition caused by muscle walls that wrap around the legs too tightly and restrict blood flow, muscle function, and nerve endings, causing the same type of pain as a heart attack. A rare condition, but it occurs most commonly in long-distance runners. Or, apparently, volleyball players who had never before had any shin problems, like me. Go figure.

The path to diagnosis of compartment syndrome wasn’t fun. I had to travel to a special clinic in Philadelphia, where they inserted a 6-inch needle attached to a pressure gauge 3 times into each leg, took pressure readings, then had me run on a treadmill for 10 minutes, and reinserted the needles to get final pressure readings. What they found blew them away. A normal pressure reading is below the number 15, with a minimal change after exercising. My pressure readings were all above 15 before running, and after running, the numbers climbed to well over 70. Compartment syndrome was the conclusive diagnosis.

While I was ecstatic that after 8 months, I finally knew what was wrong with my legs, I had a choice to make: I could stop playing volleyball and living an active life, or I could get surgery. I had to make the choice for surgery. I needed to return to my team. I needed to return to my active lifestyle. And so on April 1st, 2015, I went in for an endoscopic fasciectomy, a surgery in which my surgeon would take miniature scissors and cut open all of the walls of my muscles in both of my shins and calves. 6 incisions and 4 hours later, I was out of surgery. My compartment syndrome was practically cured.

Recovery. I can’t even begin to explain how weird it was re-learning how to walk. But after a week on the couch, I was determined to get back to school and get on with my life. Hobbling around on crutches, with a good two inches of bandages on my legs, I went in for my first post-op appointment, hoping to get cleared to come back to school. What I saw underneath those bandages was completely unexpected. Two of the incisions had been stitched too tightly due to swelling, and the skin had died, turning it black. My surgeon was concerned, but took the stitches out anyway. I was clear to come back to school and hopefully heal for the last month of the semester.

Unfortunately, those two dead incisions turned into two very infected incisions. I had no idea either was infected until one developed large blood blisters and one of them popped; if I hadn’t discovered the infection, I could have very well lost my leg. In order to prevent the spread of infection, my doctor reopened one of the incisions and instructed me to pack it with saline-soaked gauze twice a day. Thanks to the help of my friends at school, I successfully walked around college for 2 weeks with a gaping 3-inch hole in my leg. Cross that off the ol’ bucket list for sure.

Surgery #2 was to get rid of the infection and place a drain in my incision to keep any infection from coming back. Originally scheduled on my 20th birthday (which was definitely a lesson in growing up!), the surgery got pushed back 2 weeks until after the semester ended, which was a blessing in disguise. That surgery went very well, and that brings the story full circle to today, me sitting on the couch, watching reruns on the Food Network and trying not to get tangled up in my drainage tube.

Life is crazy sometimes. After this whole ordeal, I’m not sure that I have too much profound wisdom to give to the world. I cannot explain why I was chosen to go through these crazy months, instead of the normal crazy months of a college sophomore. I do not know why my volleyball season was cut short or why I wasn’t able to perform to the level that I had worked so hard to reach. I do not know why I had setback after setback on my way to recovery. People would remark that I was a "trooper" or "mature" or a "strong woman of God," but most nights I just wanted to cry and most mornings I didn't want to get out of bed to face the day. Even after recounting my story, I still think it is as wild and unexplainable as when I experienced it.

There are many things I do not know. But there is one thing that has remained certain:
In this crazy journey called Life, in my darkest and most suffocating moments, there is Someone--my Rock--who is always seeking and searching for me in the darkness, promising me firm ground on which to stand when all else falls away. It sounds incredibly cliché, but I truly feel that to understand God as a Rock, Shield, and Buckler, you have to experience Him firsthand as all of those things, without any other—pardon the pun—legs to stand on. When you find yourself surrounded by confusing darkness and the very ground you’ve built your existence upon seems to be falling into oblivion, you have two choices: you can fall apart and fade away with that ground, or you can thrust your fist into the air and place all your hope in the belief that the God of all salvation will hold you fast. And, through the little things like my mom driving to college at the drop of a hat to help me get around, strangers holding doors and writing anonymous notes, and my friends volunteering to take me to Starbucks (addiction never sleeps) and to shove gauze into my leg hole (see above picture), I experienced exactly how God uses earthly vessels as instruments of grace. And so, with an otherworldly cheeriness and with my signature slight tinge of snark, I’m going to face my twenties a little battered, a little scarred, but completely submitted to whatever else God must hold me through.

Because life, and the people I get to go through it with, truly are the greatest.
Even when limbs are not.

The LORD is my rock, my fortress, and my savior; my God is my rock, in whom I find protection. He is my shield, the power that saves me, and my place of safety.
The Book of Psalms, Chapter 18.