Sunday, August 4, 2013

PVNS = Persevering Victoriously Never Stopping

When I received the MRI results of my ankle two weeks ago and I tried to interpret some of the words like; significant distention, heterogeneous mass, degenerative changes, cystic changes, effusion and bone erosion it was pretty freaky. I knew the results weren't good when I received the initial call from my sports doctor and he said I needed to see a surgeon to get the junk in my ankle cleaned out.

From that day two weeks ago until I actually had my appointment with orthopedic surgeon on Tuesday, have been difficult. I think the "not knowing" the next steps caused me a lot of anxiety.  I felt as though my life was on hold.  I tried to remain positive and encouraging, but deep inside I was met with a lot of mixed emotions, specifically anger and sadness. So two days before my appointment, I went against my sports medicine doctors suggestion to not run.  To my surprise, I actually had a pleasant and not so painful 6 mile run.  Completed in a little over one hour, I finished my first "Santa Cruz - Wharf to Wharf" 10K Race.

Santa Cruz 2013 - Wharf to Wharf

On Tuesday I met with the surgeon and he confirmed that I do have Pigmented villonodular synovitis (PVNS).  A rare joint disease characterized by inflammation and overgrowth of the joint lining. His recommendation is to remove the mass surgically.  In my case the doctor is leaning toward open surgery over arthroscopic.  He's unsure if he would be able to remove the entire mass arthoscpically.  The mass is on the front and backside of my ankle, along with a couple cysts on my ankle bone. The good news was regardless of the type of surgery, he sounded optimistic that the recovery time would be the same; 4-6 weeks followed by physical therapy. I should be back to normal within three months total.

Top Left: The arrow is pointing to the PVNS mass.  Top Right: The arrow is pointing to the bony cysts on the ankle.  Bottom Right & Bottom Left: Additional views of MRI

Of course I have concerns based off what I read online about PVNS recurring in many cases and he did say there is a chance it could.  If it did, when and if necessary the PVNS could be removed again. The mass that will be removed will be biopsied to ensure my PVNS isn't an extremely rare case of cancer called Synovial cell sarcoma.  PVNS is rare that statistics show that only 2 in 1 million people get it a year.  I feel pretty confident that although I am a unique (*wink*wink*), the probability that the PVNS is malignant is pretty rare.

I see this as another journey, something I will be able to share with others.  My faith that God will be with me through this makes it possible to find comfort in knowing there is a reason this is occurring.  Maybe it's a season to slow down. And because I have difficulty doing it on my own, perhaps during this time I will be given the tools to learn how to do that.

For now, I've been given the okay to do what my ankle can tolerate. Today marks  60 days to my surgery date. And what it also marks is 60 days of challenging myself.  Between Sunday, August 4th and Friday, October 4th I have several goals to attain - Physically and Spiritually. 

I've made my physical workout schedule and YES this includes a RE-DO of INSANITY, a few more runs as well as preparing my legs for my 175 mile - MS:Waves to Wine Bike Ride near the end of September. 

I commit to train smart and not push myself to injury.  I'm reminded when I feel the aches in my leg and ankle, that my body is a blessing and I have to care for it, not abuse it. In order to learn this it has taken self-discipline (to stop working out when I need to) and self-control (not to push to hard).  This has been something that took practice and quite some time to understand.  Although I can be driven and determined, if I'm not careful this can point me in the wrong direction. Additionally, caring for my body means reverting back to healthier eating habits as well as filling my mind with God's word and developing a plan to help me achieve goals that will help me grow closer to Christ. 

Staying FIT for Christ isn't just about your physical fitness but also about developing your mental fitness!

As for my PNVS, I plan on sharing this experience thourhg my blogs.  As I've researched PNVS, I didn't find a whole lot of information of others experiences, particularly those with PNVS in the ankle. 

So let me start with a quick background about the history of my ankle.
In 2005, weighing approximately 205+ pounds I sprained my ankle during a soccer game.   I didn't roll it the normal way, weight bearing on the outside, but with the weight being toward the inside. I went to the ER and was told it was broken.  Three days later, with X-ray in hand saw an orthopedic surgeon. He told me it was not broken.  I was put in a walking boot for 8 weeks.  No follow up care and no physical therapy on this ankle. After healing, I began playing soccer about 3-5x a week.

In 2008 I sprained the other ankle.  A different orthopedic surgeon put me in a walking boot for 6 weeks and then began physical therapy for 6 weeks. At that time the physical therapist noticed my other ankle had a lump.  I had told her it's been that way for some time.  I had a few therapy sessions on that ankle but the main focus was on the recent sprained ankle. Once released from physical therapy I began playing soccer again (indoor and outdoor) about 3-5x a week.  During that time I noticed my lumped ankle becoming sore and would swell more frequently.  I didn't think anything of it.  I figured I was compensating for my recent sprain. 

Fast forward to 2010....I began running, attending boot camps, hired a personal training and continued to play soccer.  During this time, the ankle with PVNS was always sore and swollen after extensive workouts.  I would tape it to keep it stable.  In 2011, I began incorporating cycling and triathlons to my workout regimens.  I began to limit how much soccer I played because the pain that would result after each game began to really effect me for days to follow.  By the end of 2011 and beginning of 2012 I was fully engaged in personal training, boot camps and began training for a full distance (140.6) triathlon. In early January 2012 I began seeing a chiropractor due to a cycling accident.  In addition to him working on my neck and spine due to my injury, he also began work on my ankle.  His therapy greatly helped me in my Ironman training recovery and although I continued to have pain in my ankle, his tissue massage seemed to help reduce the amount of it and swelling and pain. 

The pain and swelling had become part of my life. I was fully aware that anytime I overused it, especially in plyometrics, soccer, or long runs, it really became sore and swollen, especially if I didn't ice, elevate and rest it days following. 

Moving forwarding to July 18th.  I met with a Sports Medicine doctor in Santa Clara a good friend introduced me to.  I gave him the same rundown and history of my ankle.  Right off from the start before any test were ordered, based off what my ankle looked like and the pain I was feeling when he applied pressure on it he was certain there was something wrong with my ankle.  The x-ray would be done first.  As we reviewed my x-ray there were no sign of breaks but there were signs of my joint effusion and mild osteoarthritis.   

He said the only way we were going to get to the bottom of the problem was to order an MRI, which would take place the following morning.  My appointment was first thing in the morning on July 19th.  The doctor called me later that afternoon with the results.  The MRI showed a mass and floating "junk." The doctor said this needed to be cleaned out and he referred me to an orthopedic surgeon to confirm what he thought may be PVNS.  July 30th, I met with the surgeon who confirmed I do have PVNS and surgery is set for October 4th.   

I'm relieved and nervous as I begin a new journey....My 60 day challenge for myself to get FIT for surgery, FIT to recover and continue to be FIT for Christ.  I know it will be difficult for me to not have the ability to physically work out during recovery.  Now is the time to mentally prepare myself for that.  The only way that will happen is to strengthen my mind, in God's word, be thankful for what I have in life today and seek how God will use me today.  

Today I was blessed to share another 10k race with my loved ones.  We all had a great time together as a family and my daughter even enjoyed her first ever chiropractic experience.  

60 Days to FIT - Aug 4th, 2013
Life is good.  I am alive.  I have no reason to complain.  I have experiences to share with others.  I have love to offer everyone. I have a God who loves me exactly as I am.  All I need is to change the way I think and BELIEVE in Gods promises.  That is truly when I will breakthrough and change will occur.  Stepping out in faith. Surrendering it all to Him! Persevering Victoriously Never Stopping!


  1. Hi Tyza,

    I live in San Jose too-- just curious as to who your doctor is? I've been seeing Dr. Mohler at Stanford for the past seven years for my PVNS. He is as far as I know one of the only PVNS specialists in the area. Let me know how your surgery goes. Good luck!

    Kris Chase
    San Jose, CA

  2. Hi Kris,

    My sports med doctor recommended a few surgeons and I choose to go with Zack Vaughn. I'm finding more and more people do have PVNS and although it's still rare, seems like more people have it than what statistics reveal?? How is Dr. Mohler working out for you? Just curious.....