Saturday, November 13, 2010

4 Months Post-op

Tomorrow will mark 4 months from my pectus excavatum surgical correction. Tonight was the first time I’ve pedaled a bicycle since the operation.


Bike: Surly Long Haul Trucker

Duration: 40 minutes

Approx. Caloric Burn: 500

Mileage: 0

Scenery: Living Room of My Apartment

I don’t think I’ve ever appreciated a lame indoor mag-trainer ride as much as tonight. As of this past week, my doctor cleared me for light exercise beyond the walking I’ve been doing. I’m ten pounds heavier after four months of being pretty much sedentary (compared to my traditional outdoor recreation lifestyle), and this is despite a whole lot of muscle atrophy. This means I am fatter than I’ve ever been, and I can’t wait to turn that around. It was necessary to take it easy for quite a while after this big surgery, but now it’s going to be necessary to ease back into getting in shape. It will take time- how much, I really don’t know. My chest still has a long way to go before I can really work out hard- my doc says bone takes a good full year before you can trust it like before it was broken (with a big break like what was done to my sternum). Plus, I’m still experiencing a lot of the “clicking” in my chest that I blogged about a few posts ago, and it’s thought now that I may have a section of cartilage that has not yet bonded to my sternum from the respective rib. So basically, it’s a bit loose, and rubbing/knocking as I move. Yes, it feels as disgusting as it sounds. I was told that it may require a third surgical procedure (at the same time as my second (bar removal)) to tie it to its place at my sternum and encourage the bond to finally happen. I don’t claim to have a great understanding of how this works; I just know I’ll really appreciate when it’s done and I don’t feel like I have parts loose in my chest cavity.

Also during my appointment, I finally got to take a look at the chest scans I had done pre-op that my surgeon used to determine both my need for correction and which procedure would be used to do it. They are pretty nuts.

This is a cross section of my chest with the orientation of looking from my waist up, at one of the deeper sections of the deformity. It really shows how badly my sternum was recessed, and thus squashing the anterior of my heart. This is why my heart could not expand normally during exercise, and I experienced high heart rates, labored breathing, and early fatigue.

This is an X-ray showing how deep my chest wall was recessed. If you know what to look for, you can see how little distance there was for my heart in between my anterior chest wall, and my spinal column. That’s my heart again, squished into the only space it could find.

And this is another cross section, now a vertical slice of my chest at a depth where it can be seen just how twisted my sternum was, in addition to being recessed. This is one of the many reasons I had to go with the Ravitch procedure as opposed to the minimally invasive Nuss procedure. My sternum needed to be broken, with a large wedge of it removed to get it into the same plane and off of my heart.

Here is a more pleasing scene- my Trucker in my living room. I was so happy to be able to handle a ride. My chest is still hurting, but it’s now pain that is tolerable and safe to exercise through according to my doctor. I was told that I may continue to experience pain from the surgical bar supporting my chest, as it can put slight pressure on nerves from time to time (as I’m sure you realize, we’re not really originally designed to have stuff lodged in us, but it works).

The Trucker felt just like I remembered, and I felt at home again pedaling after thinking about it for too long. I’m not sure the full fenders, racks, and frame pump were needed while touring my living room, but they come with the ride. Nor do I suspect there’s even that many Long Haul Truckers even getting slaved to mag-trainers; generally they’re just not the “training” folks pick of bikes. Bike Snob NYC would have something to say. But it was the upright geometry I was looking for in a true recovery ride. I look forward to more non-eventful, safe, and lame trainer work through the winter. Then I’ll be ready for something real when the spring comes. I’m coming back from the couch.