January 2018-Fully healed! …and nutritional supplements

1AC_4975It has been 14 months since Mia Rose’s lisfranc injury and reconstructive surgery and I am very happy to say that she is back to 100% healthy! She no longer gets swelling in her foot and is able to do everything she did before and then some. She’s back in competition season and only wears the ankle brace on floor and vault at this point, just for a bit of added protection. Here’s a VIDEO of the upgraded vault she working on now. And videos of both her competition vault and floor routine from the last meet.Switch ring leap during floor competition

A number of people have reached out to ask about the supplements that she used to help with her recovery so I thought I would share them here. I am not a medical professional, just a mom who did a tremendous amount of reading through medical journal articles to see what might be able to help my daughter. Based on the studies these are what I chose and why. Several are good for reducing inflammation and pain and also to help with reducing the presence of a couple of different enzymes that are responsible for the degradation of cartilage in arthritis. Since post-traumatic arthritis is a high risk with joint injuries we’re all over anything that might be able to help and has a good safety profile. I spent far too many hours of combing through articles on PubMed…but they seem to help her so it was worth it. ūüôā I included links to the places we purchase them from, but there are of course many other options for where to purchase.
Vitamin D with K for bone healing: every doctor we consulted with before her surgery recommended that she be on this since it is so important for bone healing.  To get the recommended dose of D +k in a single capsule the best product and price I found was on Amazon: https://www.amazon.com/gp/product/B01GGFDVUI/ref=oh_aui_detailpage_o09_s00?ie=UTF8&psc=1
5-Loxin (a bioavailable form of boswellia): this one has anti-inflammatory properties and has been shown to reduce the presence of an enzyme associated with degradation of cartilage   https://www.vitacost.com/vitacost-synergy-5-loxin-akba-boswellia-extract?q=5+loxin&ta=5+loxin
Meriva: also for anti-inflammatory properties (the most effective form of turmeric sold in the US according to the studies that I read) https://www.vitacost.com/source-naturals-meriva-turmeric-complex-500-mg-120-capsules-1
SAMe: this one is good for both joint function and mood (mood is not why we use it)¬†SAMe is one of the only substances that I found in the medical literature that has been shown to improve healing of injured cartilage. (In animal studies since they can’t intentionally injure human’s cartilage to see what may help with healing.).¬†¬†https://www.vitacost.com/vitacost-sam-e-400-mg-60-enteric-coated-tabs-7
Ease: this one is a blend of natural ingredients that we had started using this for periodic aches and pains from working out prior to her injury and it helped to provide relief as she was recovering too. https://plexusworldwide.com/performance/product/plexus-ease-capsules

Things keep getting better.

New video20170429_170041¬† ¬† It has been 3 almost months since the screws were removed and exactly 6 months since the injury, and Mia Rose continues to see improvement in her foot and her left leg overall. The general consensus is that you continue to see improvement throughout the first year so she’s at the halfway mark and doing really well. She tapes her arch (to support the whole arch/underside of the foot) and wears an ankle brace for preventive ankle support while at practice and she is now able to do everything she wants without any problems. She still sees some swelling at the end of the day both in the gym and on weekends out and about, but it isn’t bad at all and doesn’t slow her down. She is even able to wear wedge heels when dressed up without a problem.

Now that she’s well into the recovery process she is working some pretty cool new skills in the gym. ¬†Here’s her new vault (yurchenko full) that she got to flip onto mats rather than into a foam pit for the first time yesterday. ¬†VIDEO I can’t wait to see what it looks like in a few more weeks. ¬†She’s working new skills on the other events too but this is the only one I’ve been around to catch on video.

5 months to the day post injury, competed successfully at Regionals!

IMG_5906Just 5 months to the day after sustaining her lisfranc fracture/dislocation (20 weeks post reconstruction and 8 weeks post hardware removal surgery), Mia Rose competed on vault at the USAG Region 7 Regional Championships. The meet included qualifying athletes from DE, NJ, PA, VA, WV. ¬†This was an amazing accomplishment considering the fact that less than 1/3 of high level gymnasts who IMG_5901sustain this injury ever return to competition, and those who do usually take a year or more to get back. Her doctor had originally told her that she shouldn’t bother trying to get back this season because it generally takes a year to get back. Mia Rose’s determination to beat the odds never wavered and all of her hard work paid off.

Her skills overall are not yet quite back to where she was before her injury (3.5 months of not being able to use her left foot at all did take a toll), but she is getting close and is doing all of her skills in all events at practice now and is moving on to work new next level skills. Every day brings new progress and gets her closer to being even better than she was before this nasty injury. Amazingly some of her skills are already even better now than they were before she got hurt…likely a combination of being physically stronger than ever before after months of 3+ hours a day of conditioning and because of all the mental practice she did when she was unable to do the physical repetitions. Regardless of why, it is a nice little perk as she works to get all of her routines to where she wants them to be and works on her new skills for next season.

Below is the conditioning that she did 5 days a week in addition to an hour of bars each day to fill each 4.5 hour practice while she was non-weight bearing. ¬†This workout was created specifically for her by the conditioning coach at her gym and was updated each week in order to continue to help her progress. It¬†wasn’t fun, but Mia Rose liked that it helped her to fill the hours of practice productively¬†and give her a way to measure some real progress when everything else felt like it was on hold. Just so that nobody worries, Mia Rose chose to continue to go to the gym and work out for her full normal practice hours while she was injured…it was not required by the gym or us as her parents. She just desperately wanted to be able to jump right back in at full speed once her foot was cleared by the doctor, and knew that could only happen if she continued to train every uninjured part of her while her foot healed.

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17.5 weeks post-op and more good stuff!

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In the middle of her 1.5 twist on floor.

Lots more good progress over the past two weeks. At states, just 17 weeks post ORIF, Mia Rose qualified to Regional Championships on vault. She is thrilled to have earned the opportunity compete one more time this season.

The other big milestone is that she”graduated” from physical therapy on Tuesday. She will continue to do her home exercises but doesn’t need to see the therapist any more. Although we adore our wonderful PT, this is great news.

I put together a video of Mia Rose’s recovery journey from diagnosis through last weekend, one more piece of my effort to try to spread hope as far and wide as I can. VIDEO: https://youtu.be/lcdl2xtRMZA

 

15 weeks post ORIF qualified to States!

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Part of the jump pass in her floor routine.

I am so pleased to be able to say¬†that Mia Rose qualified for level 9 States in both floor and vault yesterday just 15 weeks after her lisfranc fracture/dislocation and ORIF surgery! Just being able to compete so soon was a huge accomplishment. At the start¬†of the week we weren’t sure that she would be able to compete floor or¬†vault as she had not yet flipped a vault or done a floor routine with tumbling and jumps in it since November 9th, so the fact that they were the events she qualified on is even more remarkable. Bars and beam were the first two events and unfortunately falls prevented her from qualifying on those, but regardless I am amazed by her drive and perseverance which paid off in the end.

VIDEOS: Floor and Vault

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in the midst of a 1.5 twisting layout.

I am immensely proud of and happy for my girl! She never stopped believing that she could come back from this injury in record time and she put in all of the incredibly hard work necessary to make that happen. She was in the gym training every single thing she could even while 100% non-weight bearing and never let the inevitable sadness and frustration that comes with this long recovery process deter her from her goals and what she needed to do to get there. She is wearing an ankle brace to help support her ankle as a precaution as she comes back from being immobilized for so long. Happily she has no pain in the area of the lisfranc repair, but all muscles in the foot and ankle that were immobilized in a cast and boot for 3.5 months get sore and she still has small limp when walking. Her surgeon and PT told her that some pain is unavoidable when returning to sports and that as

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Some beautiful moments on beam despite a fall

long as it doesn’t get above a 4/10 and doesn’t last more than 2 hours after she stops working out that she is fine to work through it. She generally ices after each practice as a matter of course and the pain is gone within 30 minutes or less…so all is well and each day she has a little less. We both look forward to the day when pain is no longer “normal and expected” but it is wonderful that it is not bad¬†and not slowing her down.

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Bars was the first event of the day which was stressful and didn’t go as expected but she still had some lovely spots in the routine.

It seems that periods of feeling really down and helpless are inevitable when traveling the long road to recovery from this injury…but having a specific goal in mind and writing down what she needed to do to get there really helped Mia Rose. Intentionally recognizing and appreciating even the tiny signs of progress seemed to help quite a bit especially as time wore on…progress is frustratingly slow with this injury compared to so many more common injuries so it can be hard to believe that you are really improving unless you intentionally notice and appreciate the little things. She still has a way to go before she is back to 100% but now it is easy to see how far she has come and there are big things to celebrate on a regular basis.

She heads back to the gym tomorrow to keep working in the hopes of improving her routines enough over the next 2 weeks to do well at States and qualify for Regionals.

Gearing up to Compete again!

20170304_150906Mia Rose has had a very busy week and a half since she was cleared to start working her way back into gymnastics. She has been working extremely hard and coming back with lightening speed. As of today her gymnastics routines are strong enough and her foot is feeling good enough that she was give the green light by her head coach to compete all-around this weekend at the last regular meet of the season.

Her goal for this weekend, of simply making the qualifying score for states would not have even crossed her mind this season¬†if she had not ended up on this lisfranc recovery journey,¬†since in the past that has not been a stretch and she has focused on loftier¬†goals. But after 3.5 months of not being able to use her foot, just 3 weeks to recover from the hardware removal surgery and 2 weeks of being allowed to do impact activities…just getting enough of her skills back to be able to compete all-around and try to qualify for states is a lofty goal indeed.

Her last two practices went well and that has left her feeling very happy and hopeful which is exactly where her head needs to be as she heads into the competition. I hope that in my next post I will be able to share that she qualified, because that would make her incredibly happy. But no matter what, I am extremely proud of how hard she has worked physically and mentally to get herself to where she is today. This is a very long and challenging road and she has traveled it like a champion and I couldn’t be more proud of her.

Cleared for return to gymnastics!

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Standing on high-toe just 13.5 weeks post ORIF. The left foot is the one that was operated on.

Mia Rose had her post-op wound check with her surgeon Monday.  It was 13.5 weeks post-ORIF surgery and 11 days after the hardware removal surgery. The incisions look good and with all the poking and twisting that he did to her foot, the only thing that was sore was the new incisions. Based on that and what he saw on x-ray during the hardware removal surgery, she was cleared to start barefoot gymnastics again. That was very happy news! She was told to gradually increase what she does over the course of the next 1-2 weeks with pain as her guide. The doctor told her to expect it to hurt a lot initially, but she is fortunate to have almost no pain and what little she does have is improving with the increased impact activity.

The last competition of the regular season (and her only chance to try to qualify for States this year) is in 2 weeks and she is absolutely determined to try to be ready to compete all-around by then if she possibly can. At the moment both bars and beam are almost competition ready and vault and floor are coming along. She was so happy to have the all clear to really start getting back to doing what she loves-she even seems to be taking the directive to work her way back gradually to heart. I am so proud of her grit, determination and hard work no matter what happens regarding competition!

She doesn’t need to see the surgeon again for two months. She will continue PT through the end of this month and then hopefully that will be far less frequent as well. Getting to the point where we do not have to go to multiple appointments every week will make our lives and her schoolwork so much easier than the past 3.5 months have been!

A good week!

20170210_124528Mia Rose’s first full week without hardware in her foot was a good one. She she only needed tylenol briefly and no pain meds at all after that and each day she felt a little better, was off the crutches after just a couple of days. She saw her PT on Monday and everything looked good. She’s graduated to more advanced exercises focused on building more sports-specific strength and balance. As a gymnast she needs to develop a lot of muscular strength to support her feet from within since she trains and competes barefoot.

Between PT, gymnastics practice and the ARP Wave work she’s doing at home every day, the atrophy in her left leg is disappearing quickly. Yesterday,exactly 1 week post screw removal and 13 weeks post ORIF, her left calf and quad measured only 1/4 inch smaller than her right. She still has a way to go, but considering that the calf looked like skin and bone when she got out of the boot and the quad was much smaller than the right one, that’s impressive. She is already able to get up on tiptoe on her recovering foot, not always easy after this injury, but critical for women’s artistic gymnastics. She’s also starting to do some additional skills in the gym. She says that her foot is feeling better with the increased movement and light impact activities. She has no pain at all in the lisfranc area…just some muscle soreness in her foot and ankle as she is now using the muscles far more than she has in months. Riding in the car makes it a little stiff but that quickly resolves once she gets out and moves.

The best thing today was that when I walked into the gym to pick her up, both of her coaches stopped me to tell me about skills that she did today for the first time since her injury and commented on how quickly she is coming back now that the hardware is out. The also commented on what a great job she has done at keeping herself strong through this long recovery. They were clearly proud of her and it was really nice to have them share that with me. Such a nice way to end what was a challenging week for me in other areas.

 

 

First full day without hardware

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Mia Rose is feeling very good considering she had surgery just yesterday. For anyone who is wondering what the lisfranc hardware removal surgery recovery is like…it is *much* easier than the lisfranc ORIF surgery! Extra strength tylenol and elevation have been all she needs to manage it. The incisions are sore but not terrible. The front of her ankle is also sore…we’re guessing from the position they had her foot in while they were removing the hardware. But she is able to use her foot without increased pain which is great.

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Using the ARP Wave system

She’s been using the ARP Wave machine lots since the surgery to help accelerate her recovery. ¬†Right now it is set for recovery. Next week she will move back into the rehab protocols to help rebuild lost muscle and improve neuromuscular patterns in order to help prevent future injuries. We are really hoping that adding this to the rest of her rehab will make a difference in both the long and short term.

Hardware Removal Day!

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All changed for her hardware removal surgery

Today is the beginning of the final phase of this recovery process. Mia Rose’s hardware is coming out! It has been 12 long weeks to the day for her. ¬†(Even though we know that many have hardware for much longer, it has felt like an eternity to her).

While she was not looking forward to another IV, post-op nausea, or incision healing process, she is *really* looking forward to being allowed to do more impact and sports-specific rehab in the near future. I will update this once she’s out of surgery. ¬†(I’m in the same day surgery waiting room as I write this.)

Surgery went very well. The surgeon confirmed that all of the joints were stable after he removed the screws which is what needed to happen.  Before the surgery we told the anesthesiologist that she woke up vomiting and miserable last time and he promised to try to make adjustments to help minimize that to the extent possible this time. The great news is that it worked! By the time we got to see her, she was sitting up smiling and ready to leave, an entirely different experience than the last time. She had no trouble keeping down the ginger ale they gave her as soon as she woke up and within 20 minutes she was happily gobbling down the container of mixed berries that we had gotten for her in the cafeteria. No nausea at all and far less groggy that the first time around!

She had some soreness but no serious pain in her foot. After getting some breakfast I took her over to the gym so she could see her coach and team mates for a few minutes and then headed back home to snuggle into the recliner with her foot up.