This post is scheduled to go live while I’m under the knife having surgery to fix issues with my left popliteal vein, the major vein that routes blood back from the lower leg and calf. I’ll lose a chunk out of my left calf — the offending part that is strangling the vein — but the good news is this will fix the circulation issues. Have a good read and I’ll see you on the flip side!
Multiple weeks ago…
I am driving my son to Kung Fu lessons, and my phone rings from an unrecognized local number. I have been anxiously awaiting a call back from a local vascular surgeon after a series of tests, so I decide to answer when I normally wouldn’t bother. I was right — it IS the vascular surgeon, and he sounds happy. He tells me that he believes he’s found the root cause of my lower left leg’s pain and numbness with exertion. There are a lot of words thrown at me as I’m driving down the dark highway, and I struggle to collect them all while piloting the vehicle. My brain records “Popliteal is completely compressed”, “the left side has no flow”, and “the right is anatomically similar but I don’t recommend surgery for that one since you aren’t having issues”. Wait, hold up. Surgery?!
Farewell, friend. (Ok, no, they’re not removing ALL of my calf, just a tiny part about the size of my thumb — but this issue with my vein has me feeling even more vain about my calves. The left one is the pretty one too!)
What’s Wrong, in Layman’s Terms
I’ve had difficulty with hard efforts on the bike since mid 2015, probably about the time I started growing mega-calves. I couldn’t articulate what was happening, but during sprints or short steep climbs my body would give out after about 30 seconds and I’d be forced to sit back down on the saddle and ease up. I was convinced it was all in my head and that if I could just HTFU and suffer more, it would be fine. This winter, the symptoms have been out of control and riding above a “recovery” effort makes my left lower leg painful, numb, and tingly.
I have something rare called Popiteal Artery Entrapment Syndrome (PAES), or something close to it since it involves the vein, not the artery. My gorgeous, gigantic left calf strangles the blood flow when I flex. In fact, it totally cuts off flow when I contract the muscle.
What It Feels Like
Imagine that you are sprinting as fast as you can and soon your leg muscles are screaming at you to stop. They don’t have enough blood or oxygen, you experience searing pain, and they may even begin to cramp. Your legs feel like jelly and don’t really respond to the commands to keep pushing hard. Welcome to my issue, but this happens to me even at easy efforts. My right leg will feel perfectly fine and have no pain, but the left will be out of control.
Why Does It Happen
The popliteal vein is the major vein that runs behind your knee and sends blood back out of your lower leg. Mine happens to be completely compressed or pinched off on the left side whenever I push down on my lower leg (standing, walking, running, biking) by the plantaris muscle. Think of it like a garden hose getting pinched shut over and over again. Under low stress activities like walking, my body can send enough blood through the hose during the “rest” times. However, when I ramp up the effort level, my leg needs more blood flow than it can get in between the clamp-downs and that’s when the pain starts.
The Conundrum … Kind Of
This problem is limiting how much I can exercise. If I do no cardio and don’t move my body, it doesn’t hurt and I have no symptoms. Zero. I debated for a few days about whether or not I should have surgery, because who wants ANOTHER surgery?! I settled on my current condition being unacceptable and my surgeon wholeheartedly agrees.
Through the amazing network of Twin Cities cyclists, I was also able to track down and speak with another woman with the same problem, who had surgery with the same doc in late 2017. After talking to her, pestering the surgeon with a million questions, consulting with loved ones, and conducting a series of complicated experiments on my body involving heart rates and exertion levels, I’m having surgery today.
I’ll have the (thankfully healthy) popliteal rerouted and part of my calf removed to allow it free passage when I flex my calf. This will keep the blood highway open in my lower leg for decades to come. (Want to get grossed out? Google has no shortage of images of people having this surgery. Yuck.) My beautiful left calf will suffer in its appearance, but scars add character, right?! Plus if this means I can ride like I want to again in the future, I’m all in. I’ll have my boyfriend around to take care of me over the weekend, dear dad for a few days after that, and then I’m on my own. Wish me luck, kids!