The Story of Achilles: Chapter 3

I was supposed to have physiotherapy yesterday. When I checked the appointment card before leaving home, it didn't have a time, but rather a note to call. So I called.

The therapist and I had a brief banter about my leg and my activities and she concluded that I could continue at home as there was nothing we could do at therapy that I could not do (better) at home. Ultra-sound was the last aspect (for the pain and nerve damage) and that was now obsolete. "Congrats and keep up the good work," she said. When I started therapy a few days after taking off the cast, they told me it would be six to nine months before I could use the leg with any real significance.

It has been four months and 11 days since surgery.

Tomorrow will be just three months since taking off the cast!

And here's the magic news... I actually jogged yesterday. Yes, there was something of a limp in every stride, but it was surely much more than walking quickly! My initial goal was to be running again by the end of the year, but it seems that will not even be a consideration. Perhaps I need to aim even higher... like climbing the Pitons again before the end of the year. Hmmm... We'll see how it goes after carnival which happens in a hair's breadth over a month from now.

Funnily enough, a friend approached me to join our parkour movement yesterday. I guess time really doesn't wait. Why should I?

The new chapter begins.

I ran last Friday.

Truthfully, "run" is just the simple excuse of a description.

It wasn't as chaotic as tumbling.

It definitely wasn't a graceful as sprinting.

It was rapid movement down a hill, chasing after my three dogs, using my legs

...

mostly...

somewhat.

The more in depth description involved a great deal of primal movement that has become second nature to me. Over the past two and half years, since adopting (as best as I can) the primal/paleo lifestyle much has changed, and even much more has happened. Today marks four months and four days since my Achilles tendon rupture. Two and a half months since I have been out of a cast. I am walking without the inverted commas/quotation marks. I am working out old-school primal/paleo style. And I am able to walk barefoot comfortably again.

*Digression: living barefoot is more comfortable to me than wearing shoes in any scenario (I consider wearing Vibram Fivefingers as going barefoot still). But with an inflexible tendon, comfort gave way to the physical inability to place my heel flat on the floor with my leg straight, hence the need for shoes with inserts.*

So while I amazed myself in moving so quickly all of a sudden, I am not so surprised that I am able to, all things considered. I have learned to adapt subconsciously to every situation I come across - be it conquer, change or submit - with remarkable fluidity. So "running" without the full use of my leg, while improbable, was not impossible for when it was called.

The Story of Achilles: How deep is your sole?

I’ve been dedicated to the strict regimen of therapy, and obsessed with getting off the reliance on crutches as soon as possible. I have become so accustomed to them, they are now accessories, toys, play things, getting more in the way than helping me along the way.

Progress.

Three insoles in my sneaker. One deep breath.

The Story of Achilles: Therapy Works

Two months post-op and I believe I've gone quite far along the road back to normal.

*sudden realisation*

Until I typed those words, it hadn't tangibly occurred to me just how long I've been sidelined. I have been simply facing each day and planning the next. This state of constantly striving for millimeters of flexibility, muscle control and abstract strength is my normal. Hmm.

I can stand completely unaided (almost, depending on wind conditions) and can now walk (hobble Quasimodo style) with only one crutch. The swelling still occurs when I forget to elevate and use the warm water bottle during the days at work. The nerve damage caused by the cast on the top of my foot which makes my toes tingle is subsiding, which indicates the ultrasound is doing what the therapists said it would. I need to remember to start a weekly photo-journal.

The Story of Achilles: Open Mouths and Pelau

Four weeks down, two more to go.

The padding in the cast, especially around my knee, is wearing thin. In less than a week I have mentally moved from apprehension to impatience towards the day the cast is removed.

I dream about taking a long, full shower. I can’t wait to float and soak in the ocean. I want to bend my knee and get back on my motorcycle, wearing my new helmets.

I have no false fantasies about running, jumping or even walking yet though. One step at a time. I really just want this cast off.

The inevitable loss of size in my leg is now glaringly evident as my thigh floats in the mouth of the fibreglass shell. My knee cracks frequently having more lateral movement available instead of its nature-intended flexions. Overall however, I am glad I have not fluctuated more than two pounds. Push-ups, pulls-ups, core exercises ensure I maintain some form and frame.

I’m having pelau for lunch.

The Story of Achilles: Fight Back

Since the stitches were removed last Friday, I have begun to come to terms with the impermanence of the cast. I made a commitment to aggressively wean myself off the painkillers. The lowered defense is most noticeable at night. Between the frequent awakenings to find a comfortable compromise in repose, and forced surrender to sheer exhaustion, I manage to meet each dawn.

Last night I dreamt about the morning after the cast was removed. In that dream, I awoke and could actually see the tendon, as though my skin was transparent. The tendon was not seamless and smooth as portrayed in medical illustrations, but more a crude experimental creation of Dr. Frankenstein - alive and functional, but by no means beautiful. I could stand firmly on both feet, but didn't try to walk. I just stood there.

Staring.

Waiting.

- - -

I am determining how to manage going back to work (physically, in the office). Sitting with my leg elevated constantly for two hours puts a strain on my lower back that requires at least half an hour of lying down to relieve. While moving around intermittently, rather than sitting continually, lengthens how long I can sit, it also means longer periods needed to rest when I do eventually succumb. I have been coping with plying my trade from home, being that the nature of my work allows telecommuting, but there is something to be said for the value of community and proximity that cannot be understated.

Perhaps this battle with the painkillers may have to be more diplomatic than militaristic.

- - -

Tomorrow will be four weeks since the day of the rupture.

The Story of Achilles: 21 days and counting

This day was inevitable. Today, my sanctuary was violated. My cast was rendered assailable.

A dull rotating hand saw carved a crude window in the fibre-glass shell, exposing my wound for the first time in three weeks. Evenly sewn stitches were removed one by one from parched, tender flesh. Flesh that had found a sense of peace in its undisturbed solace of inactivity. Although gentle and amiable, the nurse had no concept of the massive, psychological security breach she initiated.

I need this rupture healed - yet - I want this joint to live in greater safety than I have provided - yet - I need to be stronger than before - yet - I want the strength of the cast - yet - I need to be free of this crutch, and these crutches - yet - I harbour conflict within: a desperate fight to step forward, somehow without stepping out, just yet.

I am constantly aware of the tendon, convinced that what I feel with every passing second is it slowly binding itself together, at a molecular level. It is equally fascinating as it is disconcerting. It commands me to rest, while preventing me from sleep.

The Story of Achilles: The Beginning

Today

The cotton padding is starting to fall apart. Three weeks into this confinement, the cast has begun to wreak havoc behind my knee. Perhaps it’s the freedom from pain, allowing me too much movement. While my surgically repaired Achilles tendon is getting the much needed rest, the rest of me is ensuring a strong frame is maintained and ready for the moment, as the cast is removed three weeks from now, when it will be required to take up the new slack.

In the fading moments of clarity before sleep envelops my mind, I sometimes liken my leg and its fibre-glass exoskeleton to captives experiencing Stockholm Syndrome towards their captors. There are panicky flashes of apprehension when I think about the day when I will no longer have the safety and security of this cast protecting my reincarnated tendon, leaving me vulnerable to the dangers of the outside world as I unavoidably, albeit tentatively, embark upon the long journey of rehabilitation. The replayed memory of the one step that went wrong sends neurotic nerve signals down my leg, and I struggle to suppress a sharp pain concocted in my mind, a haunting feeling I yet cannot escape.

The following is a retrospective journal of my injury, and the subsequent days.

February 2, 2011 - 1715hrs

After months of excuses, citing reasons both valid and vapid, we’re warming up, jogging towards the stadium to wean our way back into the lifestyle movement we boast - parkour. Now warm, stretched, and bursting with a youthful pride belied by our true ages, we begin practicing wall climbs. The familiar motions come back with repeated attempts.

The confidence returns.

The walls get higher.

At 12 feet, I say, “I can make that.” My fingertips graze the top on the first attempt. With an air of [ ... ], I take an extra step back and proclaim, “I’m making that wall!”

I charge the wall.

The first footplant is solid.

The second is almost gravity defying.

The third is ... *pop!*

Gravity, no longer defied, catches up with me and I return to earth, rolling out of the inevitable crash with second nature fluidity. But something is wrong. It’s not my twice dislocated ankle that is hurting... in fact, there is little pain whatsoever. Just a definitely wrong feeling. I try to stand and promptly keel over face first. Now, the pain roars from behind my ankle. I look down at where my Achilles tendon should be, and see no tension in the skin. It is completely ruptured (a fact that will only be confirmed 16 hours later, as I am being admitted to the hospital for corrective surgery).

February 4, 2011 - 1400hrs

Its taking me a while to get the piercings out by myself, having lost the argument that none of my adornments are anywhere near my leg, much less foot. Most of the people in Victoria Hospital’s Ward 9 are staring in unabashed curiosity at the tattooed man without bandages or an IV drip, who lies among them, who is now struggling to unscrew, unclamp, and unhinge stainless steel rods and rings from his face and chest. Two orderlies saunter into the ward, wheeling a gurney between them. One stares, the other simply says, “It’s your turn” as he tosses me a gown. A gown known by some other standard, I muse as I stare at the floral patterned sheet with no holes, but lined with clips and strings.

1430hrs

It takes a while for Dr. Ali, the anesthesiologist to deliver the epidural, much less find the correct gap in my vertebrae. I am, it seems at the wrong end of a genetic joke, having the unfortunate physiology whereby my only susceptibility to tickles is my lower back. Within minutes though, I am reluctantly experiencing paralysis from my waist down. Physically reluctant to so utterly relinquish control of my body, but, as I was to be awake for the operation, I was rejoicing mentally.

Throughout the prep, and while getting through my flesh to the meat of the matter, the surgical team share the latest gossip. I am somewhat calmed by the fact that this is one of the most common sports injuries and corrective surgeries.

Then Dr. David exclaims, “Whoa! This is the most interesting rupture I have ever seen!”

It's quiet for a few seconds as they all look at my injury.

“Can I see?”

I twist my neck to look squarely at one of the nurses who I earlier spied placing her phone on a counter in the theatre. She looks at Dr. David who I assume assents, then retrieves her phone. I hear a click and she shows me the most interesting rupture they had ever seen.

“Cool” is all I can muster, before the reality that I am looking at my own ankle sets it.

My heart rate involuntarily climbs, and Dr. Ali gives me something cold to relax. It feels like cold little metallic nano-bots creeping in from the IV, up my arm and into my head. Slowly, the table across the room starts to dance, and I remember that I am in surgery, not mortal danger. Dr. Ali talks to me for a while, and I am aware that my heartbeat is once again slow and steady. It’s going to be ok.

1500hrs

I’m sitting in Ward 9, trying to screw, bolt, pinch my piercings back into my skin, paranoid that in the hour they’ve been out, their homes would have been foreclosed. Once again, I have an audience. The nurse patiently waits for me to finish and instructs me to lie back and relax as she fixes a saline drip to my IV. I tell her I feel fine, but she insists, knowingly informing me that although surgery is over, the worst is yet to come. My wife and a few close friends come by and we all comment and joke apprehensively about the cast and the days to come.

February 5, 2011 - 0215hrs

The nurse was right.

1700hrs

I am discharged. I manage to get to the car on my own, very slowly, with the crutches.

February 6-11, 2011

Day and night blur beyond recognition.

There is an ever-present disorientation.

There is a pain in my back and neck that feel like Death setting up camp in anticipation.

This horror is constantly searching for a fault in the heavy painkillers barricade. The battle leaves me extremely fatigued from the simplest actions. I estimate times passing by counting the remaining medications and remembering what I last ate. Self pity is impeded only by the realisation of the burden I have put on my wife’s already laden shoulders.

February 12, 2011

My aunt, a medical professional suggests that the heavy painkillers I am on are actually inhibiting my recovery at this stage. I switch to a lesser medication - 400mg Ibuprofen. The effect is almost instantaneous. Within hours, I am able to sit up and eat an entire plate of food in one go. By the evening, relieving myself is no longer a desperate, daunting task. I can feel the rest of my body regaining it’s former control and strength returning. More importantly, the debilitating pain in my spine and neck is diminishing noticeably as my spinal fluid is restored.

With my burgeoning mobility and awareness, I begin to understand that it is neither my injury nor the surgery which are truly painful. Recovery is the most difficult part of the process - physically, mentally, and emotionally.

Even more so for my wife.

Progress. Maintenance. Life joy.

Before and after ... left to right, just to be certain.

The current form is maintained wholly through the Primal Blueprint lifestyle. I only "workout" once a week, but maintain fitness as a part of everything I do, everyday. Holistic hunter-gatherer nutrition however, not a daily diet per se, is the primary key.

Regress to Evolve?

So it looks like I'm on the right path. We (humans) really do need to acknowledge what our ancestors achieved in order to fulfill our own potential. Just to recap... I did P90X for 2 and a half cycles last year and plateaued. I actually began regaining the weight and worse yet, fat (gasp)! Then at the start of this year I did Insanity and was blown away - reference: I am 5' 5" and went from a beefy 175lbs 34" waist down to 155lbs 28-30" waist!)
But nearing the end of that program I began to ask, "What next?" Then I discovered MovNat, Primal Blueprint and barefoot living.
It started, as do all things with the diet. Going (and being) primal takes us back to a time more than 10,000 years ago when mankind didn’t eat agriculture as we do today. Today my nutrition is guided primarily by a sensible practical diet of meats, seeds, vegetables, fruits, butters, fats, oils and nuts. I try as best as I can to avoid grains and sugars and food based on these two ingredients... not as easy as it sounds, believe me. After getting a firm grasp on nutrition, changing my lifestyle and approach to life as it comes came almost effortlessly (save the curious looks and awkwardly phrased inquiries from family, friends, co-workers, etc. - especially the barefoot living part LOL)
Well it's been almost two months (including a fabulous three week vacation) since I have been part of a regular scheduled fitness regime and I am even fitter and stronger than before without having padded back on the extra weight. At 33 years old, I confidently lead a parkour group, seem to be the guru of fitness, nutrition and recovery among family and friends, and I play where I work, live and everywhere in between.
I am happy.

And then... what next?

After some extensive parkour training in climb, vault and jump, I decided to allow my knees some recovery time and 'take it easy' by doing P90X instead of Insanity for a few days. And in this, my last (prolonged) week of Insanity, I am becoming more and more aware of some issues as this program comes to fruition.
All of these workouts (Insanity, P90X, 10 Minute Trainer) are designed to get you in a certain shape within a set time frame. Stick with the nutrition and training and you will achieve remarkable results, but they are not designed to keep you fit forever - they are made with a start and an end, to reach specific goals. They are a the vehicles to a destination, they are not the journey.
What do you do after your one two or three months are up?
Repeat the program, or switch to another? Our bodies aren't made to withstand the constant high intensity indefinitely. Given enough time and repetition, each program will cause you to plateau at some point, and in some cases eventually regress.
Forget Carnival / Summer / vacation / whatever the short term goal may be. What are you going to do to stay fit for life?
Think about it now so that you aren't lost... and more importantly, so you don't lose all that you have so deservedly gained. But then, now that I am in the shape I want and need to be in to have the fun I want to.. what next?
After discovering that he helped develop P90X with Tony Horton, I've been following Mark's Daily Apple for a while for guidance and tips in real-life nutrition and fitness. Enter the Primal Blueprint and MovNat. Their approaches to life, health, diet, well being, fitness, mentality, just about everything, are so close to what I have previously idealised as my own, that I feel like the new guy in the cult. My parkour training, my homespun diet, my view on social interaction, my (the list goes on) all suddenly seem to fit into a larger picture of thinking that isn't so radical... but more natural than ever before.
Time to go out and explore...
Just me musing on 'what next'.
Until such time, keep pressing play :)