Friday, January 4, 2013

Bump in the Road

MI Athletes Start First at Boston (click for music link)
I am always amazed at how quickly atrophy occurs when muscles are not used in the manner for which they were designed. My right leg lost quite a bit of volume and tone when I could no longer run back in 2007 and especially after my surgeries when I could not use it at all. Once I started running again this process was mostly reversed, with my right thigh nearly returning to the same size as before all this unpleasantness began.

In 2012 I experienced two significant events that caused far more atrophy than would have normally occurred, the meniscectomy of my left knee and then cellulitis on my residual limb. Although my right calf muscle does not function as it once did, when I run it does fire and maintains some tone. With all the time off last year my amped leg got smaller.

Swelling along fibula (right side)
Early in November I visited ProCare to be fitted for new prostheses. My residual limb had changed in shape and volume to the point I was wearing 9 -10 plies of prosthetic socks in my sockets. I was having pain when running until I could get my sock fit just right, which means running on the treadmill until I felt discomfort, getting off and adjusting socks, then trying it again. Usually after a couple of miles I could get the fit good enough to venture outside for a longer run.

This isn't like any issues able-bodied runners face. Closest example I can think of is this: imagine having a size 6 foot and only having size 12 shoes to wear. The only way to keep the shoe on your foot is by adding socks. Sure you can put on 6 or more pairs of socks and keep the shoe from falling off, but you'll find it very awkward to walk. Running - especially what it takes to train for a marathon - would be extremely difficult.


Skin breakdown on end of tibia
My insurance company denied my new legs. Best I can tell it is because I already have prostheses. Doesn't matter if my body has changed or not, too bad. So now I am facing additional injuries from a prosthesis that does not fit. Already I have swelling along my fibula that is worse the more I am on my feet, my patella is swollen from the number of socks I have to wear to keep the pressure off the distal end of my fibula, and from time to time I get skin breakdown. The fibula head has all the hair rubbed off from friction.

The last time I ran I used 14 plies of socks. I have to get my residual limb tight within the confines of my socket to minimize the pain I get on the distal end of my fibula, which manifests itself as a very sharp stab or as a world class friction burn. It is a bit odd that it is worse when walking than running.


I had an office visit with my surgeon, Dr. Ohlson, and we are going to appeal the insurance denial. My life is different from most amputees in that I enjoy running and my activity level is the highest K4.

Dr. Ohlson understands everything I have been through to get where I am, he is one of the most caring, competent, and compassionate physicians I have known. Having performed my two surgeries, no one can possibly know my situation better than he. We are asking for nothing that I am not needing for living my life. Prosthetics are not a luxury item but a medical necessity.


With the Boston Marathon a little over 3 months from now, I cannot afford weeks of downtime nor do I intend to let the present discomfort deter my training. What will happen will happen.

My fitness level is not what it was a year ago. Then I was running over 60 mi/week; now I am in the mid 40s. My times are far below what I could do then, in fact slower than almost 2 years ago. I cannot do shorter training runs very well because the number of socks restricts my knee movement so much so that I have to change my gait to avoid toppling over. For now I am doing what I can do; if not faster miles then I will do as many as my body will allow.

These are not excuses, just the facts I have to work with. It is frustrating knowing I am being held back not by desire but by things external. My current running prosthesis is extraordinary technology; however it has to fit my changed anatomy to work near optimal levels. It is now over 2 years old and can no longer function like it once did.

Short of my fibula breaking from the additional stress I am now experiencing, or a piano falling from the sky onto my head, nothing is going to keep me from Boston this year. I am training for all types of weather we may experience, and I hope by race day my times will be coming back closer to my ability. It is also my hope that I will be running in a new prosthesis as well.

I have money to raise for Ashley and the IFOPA. I have a date with my destiny. This is meant to be. I need to be on that starting line with my fellow runners Kelly and Shariff. My guides Randy and Mike will be ready to go. My wife Jennifer will be my rock when I am losing my race day mind. And we will run with the spirit of Jason Pisano in our hearts.

This is meant to be. Let it.


Wings wings who gave you your wings

Who made you lighter than air?

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