Just keep plodding

So the cortisone injection hasn't made much, if any difference. Despite regularly going to the gym and swimming a mile at a time and/or cycling 20-25km I still can't walk comfortably. I'm having to take Tramadol to deal with the pain. This is having an adverse affect on my mental health, as living with constant pain is wearing me down. I feel like I'm limited in what I do. I'm having to use my crutches almost constantly.

So I was scheduled to have a treatment known as GPS on July 2nd. Arriving at the hospital at 7.30 I was quickly settled into a 4 bay room where I went through the general questions and consent forms that are necessary with any medical procedure.

My left leg was marked up so that they made sure they were doing the procedure on the correct foot. 

Then I was whisked off to theatre. Despite the procedure being done under local anaesthetic it has to be done in an operating theatre for safety reasons. After numerous checks to make sure I was who they said I was, and hadn't hopped off the trolley and smuggled an impostor in, the registrar cleaned my foot with antiseptic and then injected the base of my foot with local anaesthetic. Oh my goodness! The pain of having that done is unbelievable, and all I could do was try to keep breathing and just tell myself it would be over soon. My foot was soon starting to feel tingly and then numb. While the doctor was waiting for the local anaesthetic to work he took some blood from my arm, 30mls to be precise. 

The blood is placed into a special tube, and then placed in a centrifuge machine to spin it around really fast. This separates the red cells from the white cells, and then the plasma part of the blood is re injected into the affected foot. 

This process takes around 18-20 minutes, and so it gave plenty of time for my foot to numb up. The doctor was happy to talk about the procedure, telling me that in 80% of cases it works and the foot pain clears up completely. The plasma is injected because the fibrous tissue in that part of the foot doesn't have a great blood flow and so this gets the healing cells straight to where they are needed. 

Once the blood had been spun, it was removed from the machine. The doctor showed me how the red blood cells were at the top of the tube, there was a pinky coloured substance in the middle which was the plasma, and a clear substance at the bottom. The doctor pulled the red blood cells out of the tube with a syringe, and discarded that into the medical waste, then he drew 3mls of the plasma into a syringe and injected that into the base of my foot. This wasn't as bad as the local anaesthetic going in, as obviously my foot was numb. 

After that had been done, and a sticky plaster placed over the injection site I was taken into recovery, just to make sure my blood pressure and pulse was ok and then it was back to the ward for tea, toast and to be presented with my new best friend, my moonboot. 

The boot is there to keep my foot and ankle in one position. For the first three days I had to keep the boot on constantly for 24 hours, then until the first week was up I had to keep it on 24 hours a day apart from when I was washing. This happened to coincide with the hottest spell of weather that Britain has had for years. Typical. Add the boot to a pair of shoulder crutches for the first week, and I was pretty much set to go home. 

Trying to stay off my feet for 3 days was unbelievably hard. I didn't realise how much I actually moved around. Getting upstairs to the bathroom, or even just from the sofa to the kitchen was a struggle. It's really frustrating when you can't get from A to B faster than a snail. After the first week I was allowed to take the boot off at night, but had to wear it the rest of the time, to give my foot a chance to heal. I noticed almost immediately that having the support from the boot helped immensely. But after a couple of days I noticed a strange feeling in my second and third toe, and it feels as if there is slight nerve damage, with my toes either feeling numb or tingly. 

I'm now a month on from the procedure and followed the instructions the consultant gave me to the letter. Unfortunately, though, despite the procedure and the rest, and the boot I am still in pain. My foot still feels tight, not so much in my Achilles, but my plantar fasciitis seems only slightly improved, I'd say around 20% better. This is really disappointing for me. I had hoped that it would work and by this point I would be pain free. 

I see the consultant again in ten days, and I'm not sure what the next step of the process is. I have read about an operation called a "plantar release". It seems that most cases of plantar fasciitis should be completed cleared by a year in, well I'm around that point now and I've thrown everything I can at it. From stretching and frozen water in a pepsi bottle, to massage and acupuncture, to cortisone and this latest procedure. I feel I'm no closer to running again than I was at the start of the year.

It's had a massive impact on my mental health. It's really hard to watch other people running races you know you would have been in, while you are sat on the sidelines with no light at the end of the tunnel. The Great North Run is in just over a month, and it hurts to know I won't be running this year. Running did amazing things to me, not only helping me to lose weight, but giving me targets to achieve and boosting my self-confidence when I reached those targets, to just having the time and space when out running to go through my mental filing cabinet and deal with the stresses of life. I desperately want to get back to that place. 

I've spoken about how depression feels for me before and how my mental health affects my life. I feel so restricted at times, and that in itself makes me angry. When I'm lying in bed in the morning and it takes all my effort to get out of it, or when I'm stood at my front door, unable to pull on the handle to go outside, when the world goes from glorious technicolour to monochrome, or when everything seems amplified, noise, sound, smells and all I want is peace, quiet and stability, when I'm doubting that I'll be able to ride this wave out, and wondering why I keep trying to get back on the surfboard when life and depression keeps knocking me off, this illness feels like it's mocking me. Telling me that I was an idiot for ever thinking I would succeed. And it takes masses of energy just to keep going. Then I go to bed at night, absolutely worn out from just existing, and lie awake, sleep eluding me, and the more I can't sleep, the more angry about it I become as I know the next day will already be hard, as I'm going to be tired. 

But life is a challenge. This illness, depression and Borderline Personality Disorder will not beat me. 10% of all people with BPD end up committing suicide and I don't want to be part of that statistic. So I keep on trying to just take each day as it comes. One fabulous achievement that I have attained is 4 years sobriety. This year has been an incredibly difficult one. There are moments when I would have welcomed the oblivion that alcohol can provide, however I know I have far too much to lose if I drink and that keeps me sober. However hard things feel at the moment, they would feel 100 times harder coupled with alcohol and a hangover. 

Each day is a journey through life. You can try and embrace it, even with the restrictions of illness, or you can give up. Personally I will do everything I can each day to hit the small targets that I set myself when depression hits, getting up, trying to keep in touch with friends and family, trying to focus on small positives. And that is all that I can ask of myself at the moment. 

Still on a sick note....

Hey there, 

Well I wish I could give you good news. But nope, I've been continuing the physio which has made slight progress. But nothing has really changed. I feel like I'm taking two tiny steps forward and one big step back. It's hard to describe because although I know there is progress it's so slow and so minimal that I don't feel like it can be measured week by week. I am better than I was back in February but not good enough to walk yet. 

Helen the physio at Physio Plus has been amazing. Not only has she dealt with the injuries to my foot and leg but she's seen me go up and down in mood. It certainly distracts me when she's trying to unknot my calf muscle if I can talk to her about how I'm feeling about being injured. Helen's tried all the conventional treatments on me for plantar fasciitis. Massage, both in my calf which knots up every week to some extent, and in my plantar fascia. That is sore, but it's the kind of pain that you know is actually doing good. She can feel the inflammation in my foot and can judge how it's doing. She's also used ultrasound therapy on the sole of my foot and taping. 

We have also tried acupuncture. I think I'm the biggest sceptic in the world when it comes to alternative and complementary therapies. But I was willing to give it a go. Helen placed tiny thin needles down my calf which didn't hurt at all. I couldn't even feel them. Then she got to the foot. Now if you think about a foot there isn't much padding down there around the bones and in the arch of the foot. So sticking needles under my ankle bone and by my toe joints wasn't pleasant, but was bearable. We then had a discussion about whether to try a point directly in the plantar fascia, basically in the arch of the foot. After consulting with Cathryn, another physio, Helen thought it might be worth a try and I just said "oh go on give it a go!" 

Helen went to put the needle in the sole of my foot, and as it went in I took off from the bed! The pain was bad enough to make me jump! That caused Helen to jump, while Cathryn dissolved into a fit of giggles. After extracting me from a supply cupboard located at the end of the massage bed (no not really) a mutual decision was made to take that needle straight out! Despite my new long jump/high jump PB from a lying flat position, acupuncture didn't really do much.    
I have to say, working with physios who actually have a laugh and a human side, as well as being professional helps so much. I'm able to be honest with Helen about what I think is making a difference and what isn't

I had an appointment with a foot and ankle specialist at the hospital too. I really didn't know what to expect when I went to see him. Helen wrote him a letter describing what we had tried. He asked me to tell him about the injury and said that he thought the first course of treatment should be a cortisone injection into the plantar fascia. My heart sank. Not just because I'd only had a needle in the base of my foot a few weeks earlier courtesy of Helen, but because I've heard about how painful cortisone injections are. But I know that this isn't clearing up on its own. So I sat on the bed and asked the nurse "is this going to hurt?" To which she replied "yes, unfortunately!" Wow, thanks for that, lol. 

Cortisone is a steroid injection which is mixed with a local anaesthetic to help it spread. The doctor felt around the arch of my foot to find where the pain was most acute then injected it. It's done quite slowly. The pain is immense I must say and I did hold the nurses hand. The local anaesthetic numbs the foot for several hours. So by the time I got to the car park my foot was completely asleep. The anaesthetic wore off though after about 3 hours and oh my god did the pain kick in. The cortisone can cause a flash reaction where the pain increases temporarily and I ended up back on my crutches for 2 days. 

Once the immediate pain of the flash wore off I was anxiously hoping for an improvement in my foot, however up to now, 8 days later, my foot feels the same as it did before the jab. I have to go back to the hospital in 6 weeks and the doctor has said he is then going to consider a treatment that is basically when my own blood is taken and injected into the damaged tendon. 

My mood has been up and down over the past few weeks. I honestly believe the Internet does more good than harm but you always get idiots. A group of keyboard warriors found this blog and decided to take the piss out of me for running, having been overweight and diabetic and my mental health problems. I find it strange that people think that by throwing something I'm completely honest about they're going to hurt me. I mean calling someone "fat" or "forest gump" is rather infantile even by my standards, and I'm not the most grown up adult out there, however I believe it said more about them than me. I'll always be proud of what I achieved through running and even though this injury has become more serious than I thought I'll get back to running eventually. 

Helen and I have discussed the running and come to a decision that 2013 is not realistic to run again as I can't walk without pain. So I'm using the rest of the year to recover and start psyching myself up for 2014. It's been hard deferring my places that I already had in runs, mentally seeing others start the road running season with aims and goals really did hit hard. But I can come back stronger next year by taking it easy and doing as I'm told this year. 

As you know I like to raise funds for charity and this year it's for David Rathband's blue lamp foundation.  I had said I'd run all year for them but that's not possible so I've had a rethink. I'm now going to swim 190 miles for the cause, which was David's badge number, and ironically the distant between the Tyne Bridge and Stafford University, as I'm a Geordie lass and David was from Stafford. I'm just thankful he wasn't Tango 1900 as 190 miles is far enough to swim. If you want to donate to my just giving page it's at www.justgiving.com/howaythelass and I'm aiming to raise £1000, to help the emergency services personnel injured on duty. Any donations are received with thanks. 

So that's where I'm at. A long way to go. But you know me, I'm not one for giving in! 

No light at the end of the tunnel

Hello, 

I bet you've all been wondering where I got to. Aye right. None of you missed me eh? Well let's bring everything up to date. Last time I blogged I had just completed the Great North Run, and had been injured at mile 5. 

I'm still injured. I went to the Walk in centre 3 times immediately after the Great North Run although they should have called it the limp in centre. I felt like something was stabbing into the bottom of my foot. I thought maybe I had a stress fracture or something but the nurse practitioner assured me that where the pain was located wouldn't suggest a stress fracture. Eventually my GP arranged an x-ray for me just to be on the safe side and it came back clear so it was obviously soft tissue damage. I thought a bit of a rest and ice and stuff would sort it. So I rested, and iced, and did some basic stretching and got frustrated as September turned into October into November and Christmas arrived with me still sore. 

I knew there was a problem with my Achilles' tendon but my foot felt so weird. It was as if I had a tight rubber band across the sole of my foot. The GP arranged for me to see the bio mechanical people at the hospital and although I saw the NHS physio I didn't really get any relief. 

When the New Year came I decided to try and run a mile to see what my foot felt like. What a mistake. My Achilles' tendon tightened straight up, the stabbing pain in my foot returned after half a mile and although I finished the mile I limped back home feeling dejected and down. 

I needed to do something. Just resting my foot wasn't making a blind bit of difference so after seeking advice about private Physios I booked in for an assessment at Physio plus in Newcastle. Immediately I felt like I was addressing the problem properly. After explaining the symptoms the sports therapist checked my legs in various ways such as stretching to see how flexible both legs were, got me to push against her hands with my feet, or stop her from moving my feet, and standing on one leg. 

She gave me a sports massage to loosen my tight calf, which wasn't the most pleasant thing when you are sore. She wasn't 100% sure what was wrong and so made an appointment for me to see the physio to check it wasn't a nerve problem as I could feel pain in my foot when she was massaging my calf. 

The following week I went to see Helen, who repeated some of the tests done the week before, massages my very tight left calf, 
massaged the sole of my foot and said she could feel tenderness and resistance in it. Then she taped my foot up. I was a bit sceptical that a bit of tape might make any difference but I walked out of the physio's that week a lot easier than I walked in.

The appointments since have seen me have my calf unknotted each week, as it seems to like tightening back up at any given opportunity, some ultrasound, which doesn't hurt, some tens therapy, which while it feels like pins and needles again doesn't hurt and taping of my foot. A diagnosis of plantar fasciitis has been made. My Achilles is also very tight and my calf is obviously a problem 
too. I can link it all back to my sore calf after the Jane Tomlinson 10k in Leeds back last July. It goes to show that not getting treated swiftly after an injury can impact massively. 

I've also seen the biomechanics department and after a similar assessment I was given orthotics to wear in my shoes, and have to go back in April. Helen the physio has suggested that I ask my GP to make a referal to the foot and ankle specialist at the local hospital to see what they believe the best treatment is for my foot as it isn't resounding very quickly to treatment and it continuously feels like two steps forward and one step back. 

I have no return date set for running yet. We have to get to a point where I can walk comfortably without pain before I can even think about that. I have found it very hard to motivate myself and have been frustrated and even depressed about this injury. I used running as a way of dealing with my stress, and seeing others progressing while I have no light at the end of the tunnel is hard. 

I'm now watching 10k's come up which I should be running but can't. The North Tyneside 10k is at the end of March and I have no hope of doing that. The Blaydon Race which I ended like a drowned rat last year is only 3 months away. It's very frustrating to not know if I'll be running any time soon.