Friday, August 23, 2013

Couch to 10 Miler Plan

Due to my surgery at the end of June, I went 28 straight days without running. This doesn’t include the week leading up to my surgery that I didn’t run my normal schedule. When I started back on July 24th, I walk/ran 1.5 miles. At this point, I decided that I needed to come up with a strategy to get back to where I was before my appendicitis. My company is a sponsor of the Virginia 10 Miler, which takes place in Lynchburg. I ran in the race last year and really enjoyed the experience. My company pays the majority of the entry fee for its employees, so it made a good target race for several reasons.

I knew I was going to have to be dedicated, in order to be ready to run a 10 mile race at the end of September. I sat down and planned out all my runs for the 9 weeks leading up to the race. To limit my soreness and to reduce injury, I concentrated on three areas; distance of each run, distance of longest run for each week, the weekly distance total. I wanted to be sure to slow step up each of these categories as the weeks progressed, but not a rate that could cause me a setback.

I am a dork and I like spreadsheets. So, of course I had to make one for my 9 week running plan. Here my final plan. All numbers (minus the percentage) are mileage totals for each day, as well as weekly total mileage. I used the weekly total distance % change  to help verify I wasn’t upping my total mileage too much.

Here is my actual mileage chart so far. Since I have been feeling good during most of my runs, I let myself add a little more distance with each run. But I limit it to only a ½ mile extra.

Monday, August 19, 2013

My Appendicitis Story

About two months ago, I had one of the more scary experiences of my life. Although, I didn’t quite realize how dangerous the situation could have been until it was over. In hindsight the outcome could have been horrible for me and my family. For the most part my life is back to normal now, but it was far from normal during last few days of June.
Anna and the boys had travel to Douthat State Park with her family on Thursday, June 20th. Since I had to work on Friday, I stayed at home and made the trip up on Friday evening. After a couple days of eating junk food and sleeping on a small air mattress with Anna and the boys, I began to have a stomach ache. I thought it was just my bowels causing me some discomfort or possibly a weird sleeping angle had caused my stomach muscles to be sore.

Sunday morning I got up and went for a run. I thought that running would help align my body. Running has always made my digestive track speed up (to put it discretely as possible). The pain didn’t go away during my run though. I could actually feel the pain in my stomach with the impact of each foot. I didn’t think anything more about it. Again, I just thought my stomach was just upset from the weekend of camping.

Monday came around and I went back to work. My job consists of sitting behind a computer for the majority of the day. So my body is not physically taxed a lot. My stomach was still bothering me. But I thought that since I had not had a good bowel movement in days, my pains were due to a “back-up”. I even tried to go for another run on Wednesday. I ran 3 miles on the Treadmill before work. This exercise still didn’t seem to get my body back to normal though.

I put up with my stomach issues for a couple more days before I decided to take some medicine. The pains I was having were very similar to gas pains. So I thought taking some Gas-X would help. After taking several doses of Gas-X, there was no change to my condition. So, on Thursday I decided to take some Miralax. This did allow me to go to the bathroom with a little more success, but I was no wear to being on my normal schedule. Thursday night, I told Anna that I thought I should go to the doctor in the morning. Not only was my stomach upset, I was developing a very tender spot in my lower right stomach region.

Since I had been having stomach issues for 8 days and I did not seem to be getting any better, I decided to make an appointment with my local doctor’s office. I was seen early on Friday morning. The Physician’s Assistant that saw me didn’t think my issue was appendix related. Since I was not nauseous and I was not running a fever, it was unlikely that I was experience an infected appendix. She didn’t want to make me get the large dose of radiation that comes along with a CT scan. She ordered x-rays to verify there was no blockage in my bowels.

She told me that I didn’t have to wait around for the results and that she would call me when she was able to read the results. So I went on to work. I worked all day and didn’t hear back from the PA until I was driving home around 5 p.m. She told me that there was no sign of blockage and that there was not a lot of fecal matter in my bowels. I found this news very strange, since wasn’t using the bathroom much all week. She told me that if I developed any additional pain, fever, or nausea, to go to the emergency room as quickly as possible.

Saturday morning I woke up and the pain was almost gone. I was very excited and I thought I was on the road to recovery. I spent the majority of the day doing yard work. I mowed and weed-eated. I took all the trash cans and recycling bins to the dump. Then later that evening, we went to the Bucannan Fair. I spent the next few hours walking around the fair and watching the boys ride some of the carnival rides. I even went down the three story slide with Eli and Coy. Anna’s mom joked that if my appendix hadn’t burst yet, the slide down would probably do it.
We got back home and had a normal night getting the boys to sleep. I was pretty tired from my long day of yard work and fair fun. I went to bed and fell to sleep pretty easily. I woke up around 2:30 a.m. with stomach pains again. I could not situate myself in any position so that the pain would go away. This was the first time I couldn’t sleep due to the pain. After an hour tossing around in bed, I woke up Anna and told her that I was in pain. I got up to get some water and I started getting the shakes really bad. I think it was a combination of being cold and having anxiety about my stomach that was causing my body to shake so bad. Anna called her mom (she is a nurse) and I put on some pants and sweatshirt.

Anna’s mom told us to go to the ER and she came over to watch the boys. We decided that we would make the trek to Lewis Gale in Salem. We have always had great experiences at Lewis Gale and it was not that much farther than the other hospitals. We got to the ER around 4:30 a.m. and we were immediately seen by a PA. Since I still wasn’t running a fever and was not nauseous, they didn’t think it was my appendix. But to be sure, they ordered some blood work, another x-ray, and a CT scan.

The blood work came back fine. My white blood count was normal, so my body didn’t seem to be fighting off an infection. The x-ray didn’t show anything abnormal. Next they put in an IV so they could put the dye in my blood stream for the scan. Also, I got to drink a wonderfully delicious drink that helped my digestive track show up in the scan results. A nurse showed up and gave me morphine through my IV. I really wasn’t in a lot of pain and I told Anna that I didn’t want any pain killers. I really wanted to know if my pain was getting worse and by taking pain killers, I figured I wouldn’t be able to keep track my pain level.

Anna talked me into, saying that “you may be having surgery today”. I laughed and said, I don’t think so. So, the morphine was injected and I felt like an elephant sat on me. I was pinned to the hospital bed and I definitely had less pain. Anna thought I was pretty funny during this time period. The PA came back and said that since my blood work was fine and I was not having any other appendicitis symptoms, that after the CT scan they would probably send me home and call me a wuss!

So, I was wheeled into the radiology department and I got to slide in the slide in the CT scan “donut” a few times. Once I was wheeled back to the ER room, Anna and I found it hard to stay awake. We had been up for most of the night and it looked like nothing was going to be found during this visit. It seemed like hours before the PA returned. He said, “You are having surgery today”! He said that my appendix was ruptured and abscessed. He said that my lymph nodes were very swollen in that area as well. He said that there could be a possibility that some else may be at work, like cancer.

No one likes to hear the “C” word. It really hits you hard when you start thinking about what might be going on inside your body. My thoughts instantly turned towards my family. Anna and the boys are my world. The thought of leaving them without a husband and father devastated me. I tried to be positive and not think about the worst case scenario. After talking with the surgeon, she informed me that it was standard procedure to send the appendix to pathology for testing. The results would take 4 week days to complete though. So I would not hear anything back until at least Thursday. She said the main thing they needed to be concerned with is getting the appendix out and having my stomach cavity flushed of any toxins.

From this point, everything started moving fast for me. I was wheeled up to the pre-op room to fill out some paper work and to meet the anesthesiologist. Anna was able to come with me during this process. She stepped outside to talk to her Mom on the phone and caught a glimpse of her crying. That was the one time I felt myself getting emotional about the surgery. I think it was more due to seeing Anna upset, than any fears related to the surgery.

They started giving me my anesthesia through my IV, and they started moving me to the operating room. I had to say a quick good-bye to Anna and got a quick kiss. Once in the operating room, I had to move to the operating table. I just remember it being cold in the room and the table was less plush than my hospital bed. Once I crab walked over to the other bed, they began strapping my arms down to the arm part of the table, which darted out at a 90 degree angle from the table. I also remember the number of people in the room. I don’t know why that stood out to me, but it made the a bit worried that this was going to take so many people. Maybe I had downplayed the severity of the situation.

The next thing I remembered was waking up in the recovery room. I was shaking violently and it was freaking me out. I asked the nurses, “why am I shaking!” and they told me it was due to the anesthesia. I do not like not being in control of my body and to lie there while my body was jerking around was not pleasant. I was not in a lot of pain, as long as I was not moving around. I asked the nurse if my wife could come sit beside me and she told me no. I couldn’t understand why Anna couldn’t come see me. I knew that just seeing her and holding her hand would calm me down.

After some time passed, my trembling subsided and I was able to relax some. They told me that all my vitals were good and that there were just going to wait a little bit longer before moving back to my permanent room. It felt like hours, but it had to only be a matter of minutes before they started wheeling my bed to my new room. As they came down the hall to my room, I saw Anna, Doug, Mom, and Dad. I felt so good to see some familiar faces again. I knew Mom and Dad were on the way to the hospital when I was going into surgery, but it was a pleasant surprise to see good ole Doug there. Once I got into my room, I had to crawl into my new bed. That was when I discovered just how sore I was.

The surgery was laparoscopic, so I only had three small holes in my stomach region. There was one just above my bellybutton and two on my beltline about six inches apart. For such a “minimally invasive” surgery, I was extremely sore. I felt like I could not use my stomach muscles at all to sit up and I felt very bloated. Come to find out, they actually fill my stomach cavity with air so they can easily separate my organs and get to the appendix. So, I think the majority of my discomfort was due to the air and having my intestines shifted around.

The worst part of the first few days was getting up to use the bathroom. Since I receiving fluids through an IV, I had to go to the restroom a lot. Anna must have helped me to the toilet 100 times over the next few days. The first day, I made myself walk down the hall a couple times. I figured the quicker I could get up and move around, the sooner I would start feeling better. It was amazing how tired I got by walking 30 feet down the hallway, very slowly. I went from running 20 miles a week, to not being able to walk down the hall without using the railing.

I told Anna that I had a new respect for her after my surgery. I was in a lot of pain because I had something the size of the tip of my pinky removed from my stomach. She had surgery twice to remove 6 pound babies from her belly! Once again, I realized why God chose women for child birth. They are definitely stronger!

Since my appendix had ruptured, I had to have a drain tube. This tube was attached to one of my beltline incisions. I came to really despise this little contraption. Although I understood it was necessary, there was no way to move around without that tub shifting and hurting!
The first night, I ate some jelly for dinner. I really didn’t have an appetite, so it didn’t really matter. I was getting pain medication through my IV for the first day. The nurse told me that once I was able to eat some food, that she would switch me to some oral pain medicine. I had not slept too well the first night. From having to get up every 2 to 3 hours to use the restroom, my leg cuffs filling with air ever other minute, and nurses coming in to take vitals, I had a lot of broken sleep.

On the second day of my stay, I was able to get some more food in my stomach. So they switched my medicine. I still had to have an IV for the antibiotics, so that was going to have to stay attached for a couple more days.

My surgeon came to talk with us the second morning. This was the first time I had spoken with her since before my surgery. She told me that my appendix did not look too good. She said that when she tried to staple it off from my large intestine, that it just crumbled apart. She was able to suture the opening closed, but they thought for a little while that there were going to have to take out part of my intestines in order to get the whole closed. Also, since I had taken ibuprofen the day before my surgery, it took an extra hour for her to stop my bleeding. She told me that appendix was sent to the pathology department and that it would take four days to get the results. For her tone and the details she gave us about how everything looked, we were very worried.

In my head, I just kept thinking how my appendicitis was so atypical. I didn’t have signs of infection. I was not running a fever. My white blood cell count was normal too. There had to be another reason why my appendix was having issues. I remembered the day before when the PA was talking about my lymph nodes being so big. After the surgeon left the room, Anna and I were emotionally shaken. This was the lowest point of my entire stay in the hospital. I couldn’t get thoughts of cancer out of my mind. Every time I thought about Eli and Coy, I cried. Every time I thought about Anna, I cried. Even though I tried to be strong and not let Anna see me getting upset, at this point I couldn’t avoid it.

A few hours later and after talking with the infectious disease doctor, we felt a lot better. I decided that no matter the outcome of the tests, I was going to beat it. Mopping around and feeling sorry for myself, was not going to make anything better. I told Anna that I was going to not think about the “what if’s” until I knew for certain what we were facing. Plus, the boys were coming to visit for the first time since my surgery and they needed to see us strong. After our visit from the boys, our spirits were pretty good for the rest of the day. I can’t even express in words what if felt like to have the boys hug on me. It was so nice to just see their smiling faces. The combination of seeing the boys, moving around more, and eating more had me feeling a lot better by the end of day two.

On Tuesday, day three, I decided that I was going to take stop taking my pain medication. I was still in a lot of discomfort around my stomach area, but I thought the medication was one of the main reasons for my fatigue. I hated getting tired for just walking to the bathroom. I needed to start getting better and I needed to start as soon as possible. At this point, were getting cabin fever. Anna stayed by my side 24/7 the first few days. My parents and I made her leave the room for a little while and get something to eat, but we even had to talk into that. At this point we had watched too many episodes of Friends, Seinfeld, and Everyone Loves Ramon (my three favorite shows of all time). I guess since I was laying the bed, Anna let me watch my shows! Anna talked me into taking some pain medicine before bed Tuesday night, just so I would get some better sleep. I gave in, but it would be my last pain medication in the hospital.
One of the main reasons I wanted to slow down on the pain killers was that I needed to have a bowel movement before the doctor would release me to go home. I was determined that this was going to happen and I learned from the nurses that the pain killers cause constipation. So on Wednesday morning, after eating a country omelet and some coffee, we had success! Now, nothing was going to stop me from going home on Thursday. I am sure if you are reading this, you don’t really care to hear about these details. But it was too important of a topic to leave out.

So after one more night in our temporary home, Thursday July 4th, I was cleared to return home. I finally got the IV out of my arm after over 4 days. I didn’t get to lose all of my new attachments though. I found out that I was going to have to keep the drain tube in for another week. I didn’t care at this point. I just wanted to go home. After a long walk to the car on someone shaky legs, we were on our way home. This was the first time I had been outside since earlier Sunday morning. I remember feeling the sun on my skin as I walked outside. It is amazing the little things in life that you don’t even realize you miss until you don’t experience it for a few days.

Mom and Dad were keeping the boys on Thursday and they were waiting on the front porch when we got home. It was so great to be at home with my all the people I love. The boys had even made a sign that was hanging on our front door, which read “Welcome Home Mom and Dad”. Even though I was well enough to come home, I still got tired very easily. I would say that was the worst complication of my whole experience. I would spend the next few days stuck on the couch in the living room. I found it was more comfortable sleeping while propped up some pillows on the couch, than in my bed.
Thursday was the day we were supposed to get the pathology results back, but since it was the 4th of July, the surgeon’s office was closed. So, I had to wait another day, now knowing if something more was wrong with me. Not knowing was starting to take its toll on me. It was hard for me to not think about the worst case, while I was sitting around the house all day. I tried to not let it show too much, but I am sure Anna knew what I was thinking about during those quiet times. Friday morning, I called the surgeon’s office, but all of the doctors were out of the office on vacation. The assistant I talked with on the phone said only my doctor could read me the results. So, I was going to have to wait until Monday.

That made for a long weekend. Finally Monday came around and I called the surgeon’s office again. My surgeon was actually in surgery, but this assistant was able to give me my results. The test came back negative! It was only appendicitis! This was the best news I had received in a long time. A huge weight had been lifted off my shoulders. I feel for those individuals and families that are fighting cancer. Just the thoughts having to start to fight something so hideous just about wrecked my nerves. During my follow-up visit with my surgeon later in the week, we found out that the results actually didn’t come back until that Monday. The pathology office did extra tests on some of the surrounding tissue and that made the results delayed. The surgeon told me that the first radiologist that looked at my CT scan had really thought cancer was involved. This is why the doctors seemed so somber when they were talking with me in the ER and the first day after surgery.

So after getting this great news, the only thing left was to keep healing my wounds. Two of the three incisions healed up very quickly. Because I had the drain tube in the other whole for an extra week and a half, it was taking longer to close. They couldn’t stitch it closed either because it had to heal from the inside out to reduce the chances of infection. I started walking laps around the back yard to make my legs feel better. I was on the road to recovery and I was looking forward the challenge. I will talk about my steps to getting back running in a different post. This post has gotten too long and I wanted to keep this one more about the actual procedure and hospital stay.
I just want to everyone that helped me over the past month. Thanks all the doctors and nurses that helped me while in the hospital. We have had so many good experiences at Lewis Gale. I would recommend that facility to anyone needed medical attention. I would also like to thank everyone that came to visit me in the hospital; Anna (she never left), Mom, Dad, Eli, Coy, Barbara, Doug, James, Brad, Emily, Ben, and Tim. I would like to thank my co-workers for sending a fruit basket and cards. Also, thanks to everyone at work for being so understanding while I was out of the office. Thanks to Tim for the basket of food and bag of stuff to keep me busy in the hospital. Thanks to Mom and Dad for taking care of my flowers, mowing my grass, and taking my trash to the dump. Thanks to my parents and in-laws for keeping the boys while Anna and I were at the hospital. Thanks to Eli and Coy for being so understanding when Daddy’s “tummy” was hurt.
Most of all, thanks to my wife. She is definitely my better half and she gave me strength with just her presence at the hospital. She helped me to the bathroom, helped me clean myself, helped me dress, and even changed my sheets while in the hospital. She fetched the nurses when I needed more medicine and she sat through hours of classic comedy sitcoms! One of the worst parts of this experience was being so dependent on other people. But she everything possible to make the situation the best it could be. I am so blessed to have such awesome people in my life. May God bless you all.