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Jason ran in his first Flying Pig Half Marathon on Sunday, May 7th and finished in an impressive 2 hr 2 min. He has always enjoyed running and trained to run the in the Pig. We are incredibly proud of his drive and determination to do this race!
Immediately after Jason finished the half, his right shin had intense pain. He was taken to urgent care where they did a shin and ankle x ray. They said his X ray was fine- that it was just shin splints and lactic acid build up from the marathon. They gave him Vicodin and ibuprofen for the pain and told him to ice it. His severe pain continued through the night. On Monday we went to see an Orthopedic Doctor who ordered an MRI that was taken at 6:00 pm. Around 8:30 pm the Ortho Dr. called and told us to go straight to Christ Hospital ER because his MRI showed Acute Compartment Syndrome (ACS) and it may require emergency surgery. While in the ER we were seen by an on call Ortho who felt that ACS could not be diagnosed by the MRI and that it was a clinical diagnosis. He felt as though Jason did not clinically show ACS and that his symptoms were from running the half marathon. Jason was in serious pain and we were told he could go home or they could admit him overnight for observation- we chose admission. He required significant morphine throughout the night for pain. The same Ortho saw him again in the morning and still felt it was from the race and not ACS. Later in the day they thought it was Rhabdomyolysis due to muscle injury from the race. The on call Ortho then conferred with a partner when he returned to the practice. We were very fortunate the partner quickly recognized it was indeed ACS and told them to book an ER. The partner got to the hospital as soon as possible and they performed an emergency Fasciotomy where the fascia is cut to relieve the pressure from the swelling of the muscle. ACS is a painful condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells, the muscle then dies. This dangerous condition, if not treated, can also lead to organ failure.
Tuesday 5/9 - 6:00 PM - Fasciotomy surgery for ACS was completed. The Dr said he opened Jason's leg and his muscle looked like "bad meat" however once the pressure was released the muscle "pinked up" and he was hopeful the muscle would not die. The incision was left open with a wound vaccum and they would do another surgery Thursday to close the incision.
Wednesday 5/10 - Jason continued to have pain in his leg but it was not as bad as prior to the fasciotomy. He could feel and wiggle his toes but could not dorso flex his foot (move it up and down),
Thursday 5/11 - Jason still could not dorso flex his foot and the doctor found that concerning but thought with time he might regain the motion. We were looking forward to the surgery to remove the wound vaccum and potentially be discharged on Friday or Saturday. When they did the surgery and found that the muscle looked dead, they made the incision larger to relieve the pressure and planned to do another surgery to remove the muscle and close the wound on Saturday. Around midnight Jason spiked a fever of 103.4. One of the concerns with muscle dying is that it's can also cause organ failure. Jason was brought to the ICU where he was monitored closely and given high levels of fluids to flush his kidneys.
Friday 5/12 - Around noon we transferred Jason from Christ Hospital ICU and into the Trauma ICU at the University of Cincinnati Hospital where they had more experience of dealing with ACS. Thanks to the support of great friends, they recommended the move and found us a great surgeon who has treated many cases of ACS. We arrived at UC around noon and they had him in surgery by 2 pm. They removed the dead muscle, lengthened his incision on one side of his leg and added another incision to relieve the pressure. He returned to the Trauma and Surgery ICU. With this dead muscle being removed, the doctor told us that Jason lost the ability to move his foot upward by himself- the action that allows running, walking, driving, jumping, ect. They are going to fit Jason for a brace (an AFO) that will help him to walk. Hopefully with the aide of physical therapy and time, he will be able to continue other loved activities like running.
Saturday 5/13 - He spiked two fevers during the night and was not feeling great in the morning. He was moved from ICU to a surgical floor in the afternoon and felt better playing games in his hospital room with all his siblings who came into town.