Page 32

Leading Medicine Magazine, Vol 7, No 1 - 2013

“The rehab center itself was a place of inspiration, where I watched others of all ages and abilities work hard and improve. Holland encouraged me to work on my own in a swimming pool, where treading water — sometimes for hours at a time — helped me regain mobility.” During the marathon, the deal-breaker came at mile 10. Like an old-style telephone cord being stretched taut then released, I felt something in my right inside ankle snap and go all loose and wobbly. Intense pain followed every movement for the next 16.2 miles. I finished the marathon, but I was in big trouble. RUNNING IS MY LIFE For more than 12 years, running defined my life. It gave me structure, discipline and purpose. Waking up at 4 a.m. on a Sunday was not unusual if I wanted to get in a 20-miler before it got too hot outside. Recording the miles, the marathons, the shorter races — it was all part of the routine to keep me healthy, on balance and in tune with myself. I wasn’t happy if I didn’t get my run in for the day. My family came with me as we traveled to races around Texas. They cheered me along the route of the Houston Marathon every year. As my kids got older, they stopped asking if I won. And, as I got older, I slowed down a lot. Since I was never that fast to begin with, it didn’t matter. Running always provided new challenges and goals. Now, here I was in Kiawah Island using my 80-year-old aunt’s cane and crawling up the stairs butt first. THE DIAGNOSIS Back in Texas, a quick X-ray showed nothing was broken, but the results of a follow-up MRI brought devastating news: I had a posterior tibialis tendon near-rupture, and surgery was the only solution. The first doctor told me, “Forget about running the Houston Marathon in two weeks, and your Florida marathon in February is a no-go as well.” By the time of my appointment with orthopedic surgeon Dr. Kevin Varner at The Methodist Hospital, I was fighting depression, gaining weight and feeling pretty sure I wasn’t going to get good news. A ruptured tendon never heals on its own, and without drastic action I would never run again. REGAINING CONTROL One look at the MRI and Varner said the entire tendon was degenerative. He recommended a tendon transfer and accompanying heel realignment. It was not a running injury, he told me, but an ongoing degenerative process most commonly seen in overweight women over 50. The transfer surgery is complex, and more people live with the problem than choose surgery. While the condition can be treated with medication, orthotics and physical therapy, a dysfunctional tendon would not allow long-distance running and certainly not marathons. “Have you ever performed this surgery on a runner who was able to return to marathon running?” I asked. “No,” Varner responded, looking me straight in the eye and saying nothing more. He always likes to leave a bit of hope for the patient, no matter what Varner believes the outcome may be. With work and perseverance, a patient could conceivably work back to the place they were before the injury. So his one-word answer was the best thing I’d heard in weeks. In that ‘no,’ I heard possibility. Varner then explained the 10-month recovery period and the intense physical therapy that would follow surgery. By doing so, Varner gave control back to me. This was something I could tackle with discipline and training. Varner would do his part and use a toe tendon to replace my broken tendon; then he would realign the heel to provide the support needed to walk and run normally. He would start me out with the physical therapy team as soon as the cast came off. The rest was going to be up to me. Varner provided the hope I needed to schedule the FDL (flexor digitorum longus) transfer surgery. LEARNING TO RUN AGAIN Nearly four months after my Kiawah Island disaster, I was in the operating room. Varner made a two- to three-inch incision on the inside of my right ankle. He took the shorter FDL — the tendon that moves the four smallest toes — and grafted it to the diseased tendon. An osteotomy was done to help relieve the load of this new tendon. Frankly, this part of the surgery was scarier than the tendon transfer. The heel was cut, moved and then two screws were inserted to hold the bones in place. Without this critical bone work, the tendon transfer alone probably would not have been enough to allow a return to distance running. I went back to work two days after surgery, using a wheelchair and then crutches. My family cooked meals, carted me around, 26 methodisthealth.com/leadingmedicine


Leading Medicine Magazine, Vol 7, No 1 - 2013
To see the actual publication please follow the link above