• Amanda Ashley

The Only Way is Through

My experiences with chronic pain started in 2003. I ended a snowboarding day at Solitude early to go home and make a German Chocolate cake. With the Solitude village in sight I caught an edge and was laid flat. Disoriented, I was unable to stand up and ride to the base. A sled ride to the ski patrol shack and the experienced eyes of a patroller determined that I had a break and an x-ray would later confirm that I had broken my tibia, fibula and ankle. FUGGGHHHHHH.

My healing didn't go very well .It took about 9 months, before it was noticed that I had a non or mal-union of my tibia and that is was not aligned. I went back to PT and started using a bone growth stimulator, the bone responded and grew stronger. At that time a remedy was offered: rebreak the tibia, straighten it and re-heal the bone. I was hesitant to undergo this procedure, as the pain that I had experienced and the limp I walked with were gone. I was ready to ride again and I didn't want to go back to a cast.

just a little bit crooked...

I failed to realize how the mis-alignment of the tibia would affect me. Over the course of the last 16 years, the 13 degree offset has played a nasty game of pinball pain with my body. I've had almost constant issues with my ankle, my knees and hips, despite how I tried to compensate. But to be fair, that wasn't the only injury that was in the mix. In 2010 while trying to move a concrete wishing well in the front yard, I 'moved' something in my low back. A couple of days of ice and ibuprofen and the pain was gone. Or so I thought, I know now that at that site a small cyst formed between my L4-L5 which displaced the nerves and sent all kinds of heinous pain through my hips and down my legs.

I did what I always do, suffered through it. Not that I didn't seek different treatments like massage and Chiro-adjustments to name a few. They just didn't provide long lasting relief. I kept running, lifting and practicing yoga, until the very movements that I loved and sought for exhilaration and release brought more pain and anguish than anything my mind could conjure. In 2017 I made an appointment with a sports ortho, he sent me for dry needling and I began working with a PT, that changed my perspective and my approach. She woke up locked up muscles, determined the exercises I needed and overtime we were able to localize the pain to my low back, between L4-L5. With daily PT exercises I was able to mitigate the nerve pain.

I started running again, but it didn't go so well. While I was able to mitigate the back pain, my ankle started bothering me. I did something I didn't think I would ever do: I gave up on running. I came to this rather sane realization on a warm Monday, as I faced the 300 yard walk from the parking garage to the building I worked in. I couldn't walk on the bottom of my foot, I walked on the outer edge, as my ankle joint was locked up, I limped and had to swing my leg out and around to walk. I consulted the same sports ortho and we started on a journey of discovery of the root cause of what was wrong with me. He ordered an MRI for my low back, and got an x-ray of my ankle. The MRI showed the cyst and I was referred to a back surgeon. The Xray showed that I had a gumball sized bone growth on my ankle joint. The sports ortho theorized that when I broke my tib/fib, and ankle: a small piece of bone had floated and began calcifying. He referred me to the Foot & Ankle Clinic. I was optimistic that a quick ortho-scopic procedure could chip that bone growth away. For the first time in many, many years I was optimistic that there was a light in the pain cave that was my body, and my hand was hovering above the switch.

In mid-May I had the cyst reduced, the surgeon was happy with the procedure and predicted that I would have good results, he wasn't wrong. High from a week of being pain free I went in to consult with the foot and ankle ortho. The surgeon, said that yes he could go in and chip that growth away, but that growth was only the beginning of my problems. The offset of my tibia was compromising my ankle joint. At the angle of my joint now, combined with the physical activity I wanted to participate in, he thought overtime I could end up bone on bone in the ankle joint. He recommended that I have the offset in my tibia corrected. When he said it, I knew it was what I needed to do. But he wanted to get an MRI and discuss particulars after he got the results.

When the MRI results came back, and we spoke again. The surgeon was surprised by the results. The offset was 13 degrees, the bone growth was the size of a gumball, the brevis tendon was damaged, my sub talur joint had severe osteo-arthritis and there were bone spurs everywhere. In other words my lower leg was a deteriorating shit-show. He recommended to correct the offset, clean out the sub-talur joint, remove the bone growth and repair the tendon. I scheduled surgery for September 18th. I discussed the procedure at length with my surgeon, the sports doc, friends, family, work and my PT. I prepped and planned to the best of my ability. But nothing prepares you for reality, like reality. I thought I would have to go through more pain to get rid of chronic pain; I was right and I was also wrong.

On the morning of September 18th I was prepped for surgery. Before I went into the OR my surgeon discussed the game plan with me, which he'd changed somewhat. Originally he was going to break both the tibia and fibula, but now he was only going to break the tibia and not all the way through. He was going to saw 7/8's of the way through, lift it up approximately 8mm and pack it with a bone graft from me and some cellular miracle goo, plate it and screw it back together. He and a Fellow in his office had spent a considerable amount of time determining exactly the best way to make the correction. Four hours later I woke up in recovery. I fuzzily remember my Surgeon taking to me, telling me that it went well, and that in 4 months I'd be back to activity. I fell in and out of awareness and slept most of the afternoon. I was happy to have my family visit me and they stayed into the evening. The nurse brought me a walker and I made probably the hardest trip I've ever made to the bathroom. But I did it.

2 plates, 13 screws...

I came home the next day and sat on my butt and scooted down the 17 stairs to my front door. I didn't go back up the stairs for 2 weeks. I stayed home, mostly on the couch. I got up for 5-15 minutes every hour. I spent my time drinking tea, icing, keeping my leg elevated, eating pain pills, taking bone mineral and calcium supplements and using all my energy to sit upright, take a shower and interact with my kids. I knew that in order to become pain free I would have to go through a big ordeal, I wasn't entirely ready for the lonely intimate moments and scary details of my big ordeal.

which helped more spirulina smoothie or opioids?

toes above nose...

Day by day though, it got better. Life kept going on, cause life happens whether you have a broken leg or not. A week and a day after my surgery, my Mother died. And the weight, the incredible sad and heavy weight of life moved in and and laid down right on top of me. I let it, I let it sink me, flatten me, fill me and flow from me. I couldn't get up and move, there was no distraction from anything during the week my Mother died and the time shortly after. Alone in my mind I had to come to terms with recovering on my couch 2,376 miles away from my Mother as she died. In long moments in the middle of the night I thought of many many things, and that's all I did. There was no resolution or solace, there never is when someone dies. Not even if they lived a long life and had a good death. They are still gone and their absence is a giant aching empty place in your life and body.

My Mother's death didn't give me a big 'aha' moment, it gave me perspective that healing from a broken leg is not such a bad thing for me to experience again in my life. I wondered why I was healing a broken leg for the second time, what did I need to learn or what was I learning? The first thing I felt was how humbled I was by the entirety of this experience. I knew that I hadn't done it alone. I had so much help, the kind of help that is a gift of love and service and can never be re-paid or thanked enough for. I was staying present, staying in place and being grateful for my life, for my family, my children, my friends, my co-workers, my neighbors, my sports-ortho, my Pt, my surgeon and his team. I know that taking care of myself is something that I haven't always done properly and that slowing down and paying attention to myself is something I have become better at. I thought of the many people I've gotten to know who share chronic pain and what our connection and the stories they have shared mean to me. I thought of all the connections I have and how very grateful I am for the relationships I have in my life. As I get through this, I realize that is the best possible outcome, getting through it, each and everyday with the people I love and trust the most.

Chronic pain has brought and taken many things and experiences from my life. It has made me question my ability, my judgement and overall motivation for being me.

Through chronic pain I lost fitness, time and experience with fitness partners, moments of clarity that only come through physical exhaustion and exhilaration, my sense of self and I often felt alone and miserable. It's made me realize that the small moments of pure joy and bliss when I've climbed, ridden on snow, run on dirt, bent myself on a yoga mat or lifted iron were absolutely worth the risks and the injuries I've sustained. Not only for the physical achievements, but for the camaraderie of my friends, the perspective and insight that travel and adventure has given me and the belief in myself that I was capable of accomplishing really fun and hard things.

Chronic pain brought me 20 extra pounds, a more twisted and darker sense of humor, friends who don't care how fast I run or how much I can lift and a deeper insight into who I am and what I care about. And now as I count down the days until my cast is off, and face a shit ton of PT, I think that there is no way out of this experience of chronic pain, and I don't want there to be. Chronic pain has forever changed and altered my life and who I am. I will feel the lasting effects of chronic pain everyday for the rest of my life and I am grateful for the support of my tribe. I know that I can endure and persevere through hard times and difficult challenges, can ask for and accept help, know when to stop and most importantly I know that not only can I keep going even when I don't know the how or the why - but that I have to - because the only way - is through.

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