After my transplant I was desperate for a blog post like this one, so I hope it gives a little guidance if you're on the recovery journey too.
Something I struggled with big time after my op was how to get back to fitness. With the best will in the world our NHS is so overrun it had no choice but to kick my ass out of hospital the moment I was safe to be let lose (10 days post op). Physiotherapists were, and quite rightly too, saved for those patients that couldn't walk, not those that wanted to run.
By the time I left hospital I had to tick a box that said I could climb a step and walk a lap of the ward. Albeit slowly, hunched over and carrying my bag of urine like a fashion accessory, I'd climbed ten flights and walked so many laps of that ward I knew the floor tiles intimately. I was free to go!
At my first check up, one week after discharge, I said, in all seriousness, and very pleased with myself, "I'm starting to feel like I'll be able to run in a week or two". An unimpressed doctor said to me, eyebrow cocked: "Although your external scar is healing well, inside we can't see how you're mending. Ellie you have had a major operation. We have to be cautious and follow the guidelines - no running for three months."
When they actually say your name you listen right?! Well listen-ish. This is the problem, these 'guidelines' [I said that in my head like a spoilt brat mimicking their mum]. The same bar is set for everybody, regardless of age, physical fitness pre-op and, how quick your decline was. So I was having none of that, sozzles, I set out on my own rehabilitation journey...
Rehab Post Trauma
I was lucky enough to get some sound advice from a few people. One piece of advice I wish I'd had and is the first I'll give to anybody in this situation is:
You will, with any luck, only be doing this once. Enjoy it!
Stop with that face! I mean it, trust me. I rushed my recovery, pushing pushing pushing. I refused to take any milestones in because all I could see was weakness in how far I'd fallen, not strength in how far I'd come back. I'd see my long walks as a 'task' rather than how I should have seen them: Oh my good lord look what I can do again! And when I did manage to start running again, I was so harsh on myself and, worse, embarrassed. By my speed, my form, my shuffling. I recorded none of it because I didn't want to remember how hard it was. I now so wish I'd recorded every step.
Constantly question your body
Do I sound a bit hippy with this one? Yeehaw! This, for me, was the only real way to recover. On every walk I'd be asking my body for feedback - Does that hurt? Do I feel better today after that longer walk yesterday, or worse? Does it still hurt if I prod there? Do this all the time and always err on the side of caution - if you think the pain is worse after pushing it a little harder the day before, then give yourself a break.
I found it really bloody difficult to find people who could give me advice - so many physios seemed a bit bewildered by me. Eventually, after three months I think it was, I spoke to a running physio who was just plain honest with me. The most valuable piece of advice was:
"You're trying to build a house on sand foundations, trying to do exercises you could do before, but you've lost so much muscle you just need to start again."
This made a lot of sense, I'd been trying to use my leg muscles again - massive muscles in the body. When I should have been starting with the tiniest muscles in my core, and working out from there...
Do this tiny but mighty exercise
The best exercise for me to build my core again was to lie on my back, fingers pressed into the muscle in my lower abs, just above my pelvis, and to slightly lift the leg until you feel that muscle engage. Do this over and over and over and over, 30-60 times, three + times a day, both sides. One day, this muscle will engage without you having to think about it (it was about two weeks for me) and when that day comes, your core will be lifting your legs again like it used to. This was the biggest turning point in my running recovery.
I was doing everything right and I still had a setback. A pain so intense, deep in my scar that wouldn't go away. This happened in week 8 on a ten minute, slow run. Rather than stop running, I continued. My surgeon suspected a hernia, I was so furious at myself I cannot tell you, and I was barely even allowed to walk. I got a scan after three weeks which confirmed it wasn't a hernia, the most likely cause was adhesions (scar tissue). For me, becoming mobile was the cure for these. The more I moved the more the pain eased. Whatever the set back, just be sure to stop, take advice that you don't want to hear and remember a small set back is better than a big one - you don't want to be as mad at yourself as I was, your mental recovery is important too and chastising yourself helps nobody.
My saviour was a spin bike! After about a month I felt able to get on an exercise bike and cycle slowly. This was amazing because it was much kinder on my wound than bobbing up and down walking. It was spin classes that helped me get my cardio fitness back way before I could use running again. Top tip - tell your instructor about your op. That way they can keep an eye on you and understand when you stop a session short or need a break - both of which I did regularly.
My running recovery Timeline
This is a very rough timeline for my recovery journey back to running. I felt like I had a strong start, then plateaued between week 8 and week 16, then progress felt good again :)
Day 0: Op
Day 3: Get out of bed
Day 4: Walk 3 meters
Day 5: Walk about 20 meters
Day 6: Walk a lap of the ward AM and PM
Day 9: Walk ten flights of stairs and many laps of the ward
Day 10: Back into the great outdoors! Slow, short walks. Twenty minutes max, lots of stops.
Days 11 - 20: Building up length of walk, always slow, lots of stops.
Week 5: First run! 5 x 10 second very very slow jog. 2 min recovery between each. Also started using the spin bike for up to 20 minute sessions.
Week 6 - 8: Build up time running, reduce time walking between, lots and lots of walking up steps. Continue using spin bike.
Week 8: Ten minute run [pain began]. Continue using spin bike.
Week 9: [Waiting for a scan, stop walking]. Continue using spin bike (almost daily) and start doing some spin classes (don't try to keep up with the class!). Start doing some easy strength work in the gym, focus on legs.
Week 11: [Scan = all clear]. Running commenced, up to 20 minutes. Spin continued. Strength work continued - legs.
Week 12: First parkrun! Stopping every 10 minutes for 1 min walk. Time approx. 36 mins (previous PB 21:02). Followed a few days later by a non-stop 30 minute run.
Week 13: Increase running distance, start running on trails again. Increase spin time and intensity, start implementing core exercises.
Week 14: First race - 1 mile. First max-effort run since the op. Time: 7:23. Hurt like hell.
Month 5: Start specific training for the British Transplant Games, including speed work.
Month 6: British Transplant Games, gold medal in the 800m. I was back!
Month 8: 1 mile race. Time: 5:47. Parkrun time: 21:13 (only 11 seconds off pre-op PB).
Month 9: I could do a sit-up again! Big moment.
Month 10: Back to Uganda to organise Running the Rift Marathon 2017, all the training was really to make me strong enough for this!
Best of luck on your recovery, remember: ENJOY IT! And be proud of yourself. Any questions just add a comment or send me an email and I'll do my very best to help :)