The Triathlon Rx

Alternate title: “they’re cutting my leg off, taking a cheese wedge slice out, and putting me back together.”

Alternate alternate title: “about damn time.”

Enough emails have come in that I thought it was time for a bit of clarification. (FIRST clarification!! NO. They’re not amputating my leg. )

Depending on how long you’ve been around DrTriRunner, you may have all // only bits and pieces // or none of my past medical history. I definitely don’t expect anyone to click on each of these links and read the entire posts, but it has ALL been documented. And what a trip for me to go back and read through them! Here is the Cliff Notes version of this entire journey since 2008…

• Sophomore year of college – was living in Boston, MA – running xc – 4 marathons under my belt and registered for #5, Boston, the following April.
• October 22nd, 2008 - Found out I have fibrous dysplasia (FD). Found out my femoral neck was fractured 2/3rds of the way through. Hahha love my title for this one: “Adam and Eve Played Me.”
• November 3rd, 2008 – Surgery was discussed with treatment team in Boston. Option 1: a surgery with a shorter rehab and greater chance of returning to running, but not necessarily a “long term fix”. Option 2: surgery with a longer rehab, lesser chance of running again, but possibly more permanent. I was still hopeful that surgery would not happen at all! If I did, it would be at home in Minneapolis over Christmas break.
• December 12th, 2008 – Written on the flight home to Minneapolis. Still praying that I wouldn’t need surgery.
• December 13th, 2008 – Post pre-op appointment, probably written in tears. I remember how devastated I was to find out I needed surgery!! Decided on option 1 with the quicker rehab and better chances of being an “athlete” again.
• December 17th, 2008 – Two days post-op. Hit heavy by Vistaril so I’m not sure how coherent that post was. Lots of cute pictures of IVs being pulled out and “learning to crutch.”
• December 21st, 2008 – Funny.. I remember being AMPED because I got to SHOVEL SNOW. Weight bearing activity baby!! It’s all about the little steps.
• December 21st, 2008 – One week post-op report. Able to use the stationary bike (next to no resistance) with minimal pain.
• December 31st, 2008 – Two weeks post-op. Able to swim and pool run once the incision had healed. I remember being amazed at how quickly [I thought] progress was happening…
• January 25th, 2009 – First post-op follow up appointment, which led to me being…
• February 6th, 2009 – Cleared to run!! Ohhh that joyous letter. I hung it up on my dorm room wall. Serious. Keep in mind – this was only cleared to run 2 x 10 minutes every other day. Although I’m pretty sure on that day that I had made up: I was still running Boston 09…
• March 10th, 2009 – Progress was going well..? By March 10th, I was up to a 10K at 7:46 avg per mile. And that was my easy pace back then.
• March 14th, 2009 – A memorable 9 miler doing the last part of the Boston course backwards, with my best friend riding along on her bike. Progress, but with the marathon a little over a month from then, that should have been telling me something about “race readiness”…
• April 20th, 2009 – 113th Annual Boston Marathon. Dumb decisions were made, and lessons were learned. There’s a reason I didn’t post from April until August… Moved back to Minneapolis in the mean time and transfered back to the University of Minnesota.
• August 15th, 2009 – [Mostly] Successfully trained for 2009 Twin Cities Marathon! Had a wonderful training group and felt fast and strong for pretty much all of training. Dropped mileage probably 25% to 30% from pre-surgery averages. Did the first 20 miler of the training block that day. I wrote in this post that the recovery process had felt “slow” … looking back, doing a 20 miler eight months after having a major hip surgery doesn’t really sound that slow…?
• September 5th, 2009 – Did my last triathlon of the summer. Froze my ass off on the bike. Took 2nd in my AG and ?? overall. I remember not being able to feel anything knee down until the last mile of the run!
• September 10th, 2009 – Did the double header of the Victory Memorial 10K/5K. Ran a slower than usual 10K and used the 5K as a cool down… but somehow took 2nd and 1st AG in each. So in my mind… I’m sure that meant recovery was on schedule, right? I also remember that during this photo <– right before the 10K start, I was thinking my hip felt a little “off.” #SOML.
• September 24th, 2009 – Spent the day at the hospital in radiology. That little “off” feeling quickly returned to the same feelings I was having pre-surgery. I knew something was up, and that something was likely no good… At this point I was trained up to the 4th 20 miler of the 2009 Twin Cities Marathon.
• September 25th, 2009 – That rainy, dreary photo at the start of the post set the stage for what was to come. I got a phone call from my doctor that morning saying the images taken the day prior showed positive for a fracture. The same fracture line in my femoral neck that was there way back in October of 2008. Now the question was, did it ever really heal, or did it recently refracture? Was it a matter of the intensity, distance, the fibrous dysplasia, or all three combined?
• October 2nd, 2009 – Pulled out of the Twin Cities marathon. My mom and I watched and cheered on my fellow teammates and training partners, and it was h.a.r.d. I want to say I was just excited for them and the culmination of the many miles put into this race, but the honest thoughts in my mind were how badly I wanted to be out there racing. Back on a no-running, non-weight bearing XT prescription.
• 
• October 30th, 2009 – After great debate, my insurance finally cleared a bone growth stimulator, which I used 30 minutes every day. I wrote that it was a “gift from my orthopedic Santa.”
• November 15h, 2009 – Somewhere in here I was cleared to run again. By the 15th I had done three half hour runs, all at easy pace, indoors on the dreadmill.
• All of 2010 – Essentially a year with a shitton of cross training. Never got back to the “old normal” running mileage from pre-surgery days, which I justified because I was focusing more on triathlon. Lots of swimming and biking, and “medium” amounts of running. March 17th took 3rd overall in the Get Lucky 7K. Finished behind Jenny Wilcox and Amy Lyons, so I was happy to be in their speedy company. Raced New Bri Tri on June 5th and Manitou on June 13th - had an off race in New Brighton, but Manitou went well and took 2nd. Played a hard core game of road kill during the run and passed 68 people! That felt good, but also remember my left lower leg hurting like $#!& after the race.
• July 7th, 2010 – Sure enough.. tibial stress fracture. A compensation injury from having a left leg that is one half inch shorter than the right. Was SO eƒƒing fed up with all these injuries creeping in due to my hip issue, but humbled at the same time that even on my worst days, I still had so much to be thankful for. Posted a bible passage that day: “Be joyful in hope, patient in affliction, and faithful in prayer.” – Romans 12:12. Important one to remember… every. single. day.
• September 22nd, 2010 – Started hitting the weights a little harder, thanks to my wonderful coach at the time, Mrs. Jodi Jones. Tibia had plans of it’s own and was taking its sweet damn time to heal. (read: it wasn’t…)
• October & November 2010 – Ran the Monster Dash half marathon at the end of October as a “fun run” but didn’t race it. Got hit by a truck mono for over a month and really impacted training and fitness. From that point until now, I’ve honestly never run over 30 mpw.
• January through August 2011 – stayed between 10 and 20 mpw, but running felt like it was on a slow decline. On April 22nd I %!&@#*> in a Friday Confessional that “running hated me”, and my body was definitely feeling that. Stuck with the cross training and strength, minimal swimming (oops!) and a LOT of biking. Put in more miles on the QRoo this summer than ever before.
• August through October 2011 – The slow decline turned to big freaking decline, and there were days when I felt like I could barely put weight on my left leg at all. Got my butt back in to see my treatment team, and we knew we needed to take action. My fracture from way back in October of 2008 was STILL not healed – something called a non-union fracture. It had never healed. A second surgery was definitely in order and it was just a matter of determining what the procedure would be, who would do the surgery, and when would be the right time.
• October through now 2011 - continued to go all over for treatment. MRIs, injections, cortisone, x-rays, CTs, you name it.

So… bringing us to the present – we finally have come to the conclusion that the best surgical procedure is a “valgus producing sub-trochanteric femoral osteotomy” … ironically, the same “option #2″ that was recommended (and decided against) way back in 2008. The option with a longer recovery time and a lesser chance of returning to running. I’m scheduled to go under the knife on December 14th, 2011 – exactly one day short of three years after my first surgery. And I’m am so excited to get. this. over. with.

In terms of outcomes for…

• time in hospital
• time on crutches
• rehab  time
• prospects for returning to running
• prospects for returning to distance running
• prospects for returning to racing

… a lot of that is still up in the air. It would be awesome if my recovery went as quickly as the first surgery, but that will be a day-by-day process. And covered in a post to come!

Aaaahhhhhh. I feel better. You might not if you read that whole thing… but I give you mad props if you made it all the way through.

This post is beyond long enough, but I just wanted to bring everyone up to speed. (And it was a good project I could do while in a post-turkey coma!) The prayers and good wishes many of you have sent this way, and the support you all provide? You all are my angels, and on this day of thanksgiving, I want to let you know how THANKFUL I am for all of you.

Reader Qs:

Have you ever dealt with an ongoing injury or illness? How did it affect your training/racing/life, and how do you deal with it now? Did you have a good thanksgiving, and what is your favorite kind of pie?

Happy thanksgiving!!

-Erika