Tag Archive for doctors

The Triathlon Rx | January 2, 2012
19 comments

Staying fit while on crutches

I am just shy of 3 weeks into this post-surgery rehabilitation period, and have another 3 weeks to go. While six weeks certainly isn’t the longest I’ve been on crutches (try 6 months!!), this is the most restricted I have ever been in terms of weight bearing activity and exercise. Despite my fears of turning into a whale… the scale has not really budged. Despite my fears of turning into a limp noodle… well,  my arms are still strong! ;)

When an injured athlete is faced with a period of non-weight bearing activity and handed the crutches of doom, all sorts of questions and fears may arise. Will I lose all my pre-injury fitness? Will I gain weight? Will I have to start over from square one? Will I be forced to give up coffee since I can’t carry a cup?! (Because really, that’s all that honestly matters.) While each athlete will have unique circumstances, I’m 97% confident I can say the answer to each of these questions is NO. Including giving up coffee!

Steps to staying fit while crutch-bound

(1) First and foremost, get medical clearance from your physician. Check what is OK, what isn’t, and keep your medical team updated as you progress through recovery.

Assuming you’ve been given the green light…

(2) Don’t check yourself out mentally!! Even if you “love” to workout, it’s pretty dang easy to hang up your handicapped parking tag over the couch and stay there for good. And what goes better with a movie than a pint of Ben & Jerry’s…?!

Don’t get me wrong – take your well-deserved time to recover and mentally/physically recharge. But don’t get too comfortable on the couch, because you will eventually be able to get back at it again, and there is no need for you to start over from the very beginning! Instead of getting down because of what you can’t do, focus on what you can. Which means…

(3) Upper body strength: Your arms will get a head start simply from using crutches, but if you’re an athlete who is used to putting in a couple of hours a day, chances are that won’t quite cut it. Free weights can be difficult to maneuver as you need  both hands to crutch, and probably shouldn’t try and grab that 35 pound DB with your pinky. Machines, however, are for the most part very doable. Push ups, yes. Pull ups, yes. (Just remember not to jump down!!) Chest, shoulders, triceps, biceps, back… you can hit em’ all.

The biggest hang up for me is that I superset all my lifts. The patience is simply not there to sit on a machine and just wait between sets. It drives me nuts!! But for the time being… I will get over it. Logistically it makes life a lot easier to take one machine at a time. If possible, try to hit the gym at a less-busy time of day.

(4) Cardio: It is still possible! Two options (that I know of… if there’s something else out there, please let me know!!): Hand cycle ergometer, and pulling in the swimming pool. Unfortunately not all gyms will have a hand cycle… but if you have access to one, I definitely recommend taking advantage of it! Forewarning: the first few times (just like when pool running) it will feel like you’re not doing anything. And/or it will feel very difficult. Possibly both at the same time. Chances are that it’s mostly mental because it’s simply not an exercise you’re accustomed to. Keep at it, and you will likely notice it starts to feel [mentally] easier, and you will actually start working up a sweat!

In terms of swimming, please make sure that any open wounds/incisions have completely healed before you get in the water!! You may be dying to get back to exercise, but not at the cost of big nasty infection. If your doctor has cleared you to get in the pool (submerged – not the same as showering!!) then hop splash to it! Assuming most readers here are triathletes, this is your golden opportunity to work on that often-dreaded portion of multi-sport. How much you can use your legs will depend on your doctor’s/PT’s orders – you may not be able to kick at all, or you may be able to do a light flutter. Invest in a pull buoy if they’re not available at your pool (usually between $5 and $10), and pull away. This is also a great time to work on stroke drills – fingertip drag, distance per stroke, single arm, catch up, rhythm, etc.

Some lower body injuries may still allow you to pool run. If you’ve been given the go to do this, and are wondering where the heck to start (or looking for pool running workout ideas!), check out two of my previous posts: Pool Running, and Pool Running Part II.

(5) Core stability: Although it will depend on what your injury was, you may very well be able to keep up your core work! Again, check with your medical team. Your regular routine may need to be modified a bit – typically the rapid, jerking movements may be best if skipped. There will also be some trial and error involved… you may find you can do planks just fine using only your “good leg”, or that Russian Twists use too much quad muscle to do comfortable.

(6) Physical therapy: This should probably be #1. If you have been ordered physical therapy, I can’t stress how important it is to keep up your exercises as prescribed!!! It may be tedious. It may be time consuming. But your physical therapists have been through four years of an undergraduate education, a competitive admissions process to their masters or doctoral program, and an additional 2 to 3 years of education. PLUS passing the National Physical Therapy Exam, as well as state certification exams. Read: they know their ****. They can determine proper exercises based on your current status, and help you advance them as you improve in recovery.

(7) Diet: No hate mail for this one please!! Truth be told, if you’re used to putting in Ironman worthy workouts every day and you’re now limited to 40 minutes on the arm ergometer, you may need to adjust your diet a bit. If your maintenance calories had been 3800… well, they’re probably not right now. Calories in = calories out… capisci?

On the flip side, if you’ve been down at that racing weight for maybe a little to long, or are one of those people who struggles to maintain a healthy weight, this could be your easy fix. If calories/eating/weight while injured is causing a great deal of anxiety, it may be worth checking in with a sports dietitian or sports psychologist for good measure.

^^ I can’t wait for the day I can get back to THIS! ^^ It was my first full triathlon (and first tri podium finish!) and I will do what it takes – even if that means being patient – to get back there! :D

In terms of other crutching tips… there are a couple things I would like to add:

  • Backpack. Or those nice little drawstring bags. Keep one with you at all times!
  • Travel coffee mugs. Lovely reader Brynna recommends the Contigo brand because she can throw them in her bag, and they don’t leak a drop! Unfortunately, most of the [ridiculous too] many mugs I have aren’t that leak-proof. I just picked up a Thermos brand “Stainless King Travel Tumbler” at CostCo, and honestly I’m pretty sure it could withstand a bomb. Put it in your above mentioned backpack and you’re good to go!
  • Remove floor rugs and their best attempts to trip you up.
  • Under-arm crutch padding… OR forearm crutches. There are some nasty injury/wound pictures lying within my iPhoto albums, but I’m glad I didn’t take one of my rib cage post-crutches. Rubbed. Raw. :(

Being injured is never fun. Ever. But keep your head in the game, and remind yourself that this just a speed bump in your life, not a road block. Do what you can do safely, and you will be back in action before you know it!

Reader Qs:

What do you do to stay fit/sane while you’re injured? Do you have any crutch-success tips to add?

-E

*This post has been added to Train on Top archives, where you can find other articles on training, cross training, nutrition, and injury prevention.

Category: Medical Monday | Tags: , , , , ,
The Triathlon Rx | December 17, 2011
24 comments

Three Days Post-Surgery: Success!!

Step #1: Make it through surgery

Check!

Several hours after going under, I heard from my parents, who heard from my surgeon that the unscrewing, sawing, drilling, and plating was successful! I have a sweet post-op xray with the new fancy hardware store, but don’t have it on a disc yet so that will have to wait! In the mean time, check out the new hospital space suit/body heaters:

Yeah… talk about instant birth control right there. They’re like hospital gowns with a vacuum hose attached, pumping in hot (or cool) air. Makes you look like the Michelin Man. Also made me feel like I was sitting in a sauna, so had to turn that bad boy down. Of course the hair net is always super attractive. ;)

What I remember before surgery is all the prep, anti-bacterializing my hip, and taking out my contacts. I remember saying goodbye to my parents and the nurses wheeling me into the OR, and I remember them transferring me to the operating table. I don’t remember them at all putting the mask with anesthesia on me, and I definitely don’t remember doing the backwards countdown or anything else until I woke up 3 minutes 6 hours later! Kind of a bummer… that back words countdown and knock-out moment was kind of my favorite part.

Step #2: Make it out of the hospital

Check! 

(Last week at the clinic with pneumonia.) With minor complications. They kept me a day longer than intended due to not quite hitting the pain management marks on schedule. Then, my second night I ended up spiking a fever of 101.5, but was freezing with goosebumps, and was super congested. You might remember that I got pneumonia the week before surgery – brilliant timing, right? – so they were concerned about a reoccurrence of that. After being intubated and staying in the hospital, it’s apparently quite easy to get pneumonia. Let’s not do that!! Several PT sessions in “the gym” (full of stairs, beds, curbs, and all the other foreseeable obstacles one could encounter), a long check-out list with a bag full of drugs, and they sent me on my way! I’m staying at my mom’s house for about a week, or until I can drive again, whichever comes first. ;)

Step #3: Physical Therapy

half check…

I’m trying to channel my inner JuliaGoBigGreen here. This stuff is hard! Knowing me, I of course saved my last big leg workout for the morning-of. (Side: my friend at the gym told me he got hell from his surgeon for running the morning of… told me you bleed a lot more. Dr. Van or anyone else… true? BS?) Anyways, did my last big legs workout and hit my heaviest squat to date. Two days later, my PT is helping me to do a simple [body weight] leg lift. Oh my GOODNESS is that ever frustrating when something so simple feels so unbelievably hard!!

   

The exercises she has me doing are the same ones a patient would do after a total hip replacement… something I’m trying to avoid as long as possible! I am doing (1) quadricep contractions (thigh squeezes), (2) gluteal contractions (butt squeezes), (3) heel slides (photo left, just sliding the heel up towards the butt and back down), (4) straight leg raise (sounds so easy, and this is by far the hardest!), (5) abduction / adduction (photo right, sliding the heel out away from the body and back in), and (6) short arc quads (place a can or rolled up towel under knee, try to raise foot off ground… second hardest).

I have to keep reminding myself that they did cut through all these muscles along the lateral side of my leg, and had to sew them back together. It’s not just the bone that needs to heal, but also a ton of muscles! I do these 2x per day, and trust me… it feels like a “workout.” So funny to think that!

Step #4: Ride power-cart at Target

check!

You bet I did… as a kid I always wanted to ride the power chairs whenever we went to target or Costco or something. You know what? They go like a quarter of a mile an hour and make you feel bad for holding everyone else up. Not all it’s cracked up to be.

What I really want is one of those ride on Power Wheels Fisher Price cars… hahha let’s go with the Dune Racer:

Here’s a “friday confession” for you – I used to babysit triplets that lived across the street from me, and they had this ride on Jeep. I’d always convince the boys that they wanted to ride their scooters or something so I could ride the Jeep. And it did go faster than .25 mph. :)

Step #5: Get off meds and DRIVE!

Next Friday.

Hopefully! I can’t drive until I’m off all narcotics (vicodin, oxycontin, roxicodone), and until I have the follow-up appointment with my doctor on December 23rd. That’s just next Friday! Being independent is something that has always been important to me, and obviously being on crutches there are a lot of things I simply can’t do because I don’t have two hands. Carry soup to the table? Nope. Reach anything out of an upper cabinet? Nope (oh wait, I couldn’t do that anyways…). So it’s going to be quite a while before I can do any of that two-handed stuff, since I’m estimated to be on crutches for the next six weeks. BUT I would sure as $#!& like to be able to drive myself to PT. What else is this handicapped parking tag good for? ;)

So chicos… I made it. It wouldn’t have been without my amazing medical team, and my supreme friend/family support squad! Your prayers, texts, emails and facebook messages of votes of confidence truly mean the world to me. You are all angels, in every sense of the word.

-E

Category: Medical Monday | Tags: , ,
The Triathlon Rx | December 9, 2011
14 comments

Friday Confessional is back! 12.09.2011

Friday confessionals returning with a vengeance!! If you’ve never played before, do a quick check of the 101. Anything is fair game, and it really is more fun to play along! ;)

1. Sick chick.

And I don’t mean sick in the way cool / sick / tight / wicked / sweet / dope / fresh / anything that doesn’t actually mean “awesome”  but yet is somehow used interchangeably. Between last Wednesday (on my birthday. Not sweet, nor dope.) and this Monday, my temperature was bobbing between 102.5 and 100.7. What started out as a Dx of strep throat turned to a prescription for amoxicillin that wasn’t making me feel any better (or cooler). Turns out that I had pneumonia, which may or may not have been due to the strep that was or was not even there to begin with. So I’ve spent a lot of time here:

   

Influenza test -> Strep test -> cute note from “Kathryn” en español!

By the fireplace, under the covers, in the dark. (Creeper.)

Thankfully, since going back to the clinic on Monday and confirming pneumonia with the chest x-rays, they switched me to levoflaxacin and I’m feeling 97% better. My grandma has had pneumonia so many times and I never had any idea how miserable she felt!! :( It was I imagine a collapsed lung feels like. (My surgeon would not have been impressed with that come Wednesday….)

2. Five days until they cut my leg off.

Yes, the countdown is going strong. With all this sick business over the last week, I can tell you I was pissed bummed about missing gym time. And I have no problem fully admitting to hitting the gym the second my doctor said “I guess if you’re feeling bett…..” I have been asked multiple times by several friends:

You just can’t give it a rest, can you?!

Not today my friend. And I will tell you what… when you have two months of ass-to-couch time staring you down, you can make whatever decision you want concerning your last five days. But as long as I have been given the green light to exercise, and am not by any chance contagious, I will sweat it out until the very last possible minute.

3. I am actually scared to death for surgery.

Sure, it’s easy to look brave behind words… to say well, you can’t always chose the cards you’re dealt and there’s no way around it, so let’s do this thing! Slowly over this last week, the reality of the lifestyle changes I’m about to face has really started to set in. We have such a small amount of snow right now here in Minneapolis, and I know it’s only a matter of time before mother nature decides to unload 2 feet on us. Thinking about crutching out to my car and trying to scrape it off… thinking about crutching downstairs to/from my apartment… thinking about how the DUCK do I carry a coffee cup!?!?! All hitting the fan.

This is a rough estimate of the procedure they are doing… which I wrote more about in this post.

The wedge that you can see gets removed, leaving a brand new, fresh surface that needs to heal together. Along with the bone healing around the screws. And plate running along the lateral side of the femur. Not to mention there is a big unpredictable tumor chunk that has, until this point, proven to do whatever the heck it wants…

It never asked me if I liked the question “Why do you walk with a limp?” (No.) It never asked me if I wanted to run just one last marathon. (I started my list when I was 10.) It never asked me how I felt about crutches when it’s -20°, icy, and snowing. (Can I take coffee with me? No? Ok, angry.) It never asked me if ever wanted to sleep on my left side again. (How about just through the night?) It never asked me how I felt being left out of any/all plyometrics. (Like I’m defective.) It never asked me how it feels to explain what fibrous dysplasia is 100billion times and have every single person you just explained it to look at you and still not get it. (#GTFOH)

4. I feel super selfish.

Reread last paragraph. I can think of an equal 100billion ways it could probably be worse.

5. The Hand Crank…

- Is really kind of harder than you’d think.
- Burns like 1/3rd of the calories you can burn while running, and still feels kind of harder than you’d think.
- Is quite possibly more boring than pool running…
- Unless you find a good song that you can get krunk to crank to… in which case it might not be so bad.
- I’m going to need a lot of new songs on my iPod.
- Is kind of lonely, since there are only two in the gym (attitude correction: there are two in the gym!) and I don’t see anyone else on them.
- Which may be a blessing in disguise because I’ll never have to wait for it.
- Unless it snows two feet, in which case my butt ain’t gettin to the gym in the first place.
- Mmmm yep, still waiting for that attitude / perspective / expectations adjustment.

And that my chicostix… is about five things more than I’ve ‘fessed up to until today. And it does feel BETTER. :) Especially number 4. It’s good to get things off your chest….

#feelsgoodman

(1000 bonus points for the right reference.)

Reader Qs: Your turn!

-E

Category: Friday Confessionals | Tags: , , , , , , ,
The Triathlon Rx | November 29, 2011
18 comments

December countdowns

It is a month of countdowns for me. FINALLY, I have a surgery date on the calendar, and even a post-op appointment set up already!! I am definitely one of those people who needs a visualization of these things to know they are actually going to happen.

Days until….

  • My birthday!!: 1 day
  • My new HOUSE!!!!: 2 days
  • My best friend finally home from 6 months in Mérida, Venezuela: 3 days
  • First two UMN gymnastics meets: 5 days, and 12 days
  • I get to see my padre: 14 days
  • SURGERY!! Can I get an aaaaamen?!: 15 days
  • Christmas: 26 days (yikes!! better get to shoppin…)
  • Post-op follow up appointment: 30 days
  • Start of 2012: 33 days
  • Possible last day of crutches? (hopefully earlier!!): 57 days (ayyye.) :(

Meanwhile… I think it’s about time to check in with my goals from 2011, and start thinking ahead to 2012!

Reader Qs:

Are you currently “counting down” to anything? How are you doing on your 2011 goals?

-E

Category: Uncategorized | Tags: , , ,
The Triathlon Rx | November 24, 2011
18 comments

Surgery: valgus producing subtrochanteric femoral osteotomy

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

Category: Thoughts on a Thursday | Tags: , , , ,
The Triathlon Rx | October 26, 2011
10 comments

Three Thoughts Thursday // 10.26.11

Ahhhhh… the little bear has awaken. :)

First of all, THANK YOU for all of the comments, texts, facebook messages, and emails that were sent regarding the last post. It’s either a really simple subject to talk about (with doctors, God, and um.. that’s it) or a kind of difficult subject to talk about (anybody not included in in category #1). The other day I realized… one of the things that puts it in that “difficult to talk about” category is that other than my doctors, no one really knows much about fibrous dysplasia. My doctors are great, but I can’t call them at 3am when I’m freaking out because I rolled onto my left side and woke up from pain. I can’t call them when I’m stressed about the amount of time this is taking to decide on a surgical procedure. And I definitely can’t call them and cry about missing practice or racing or my team. (p.s. If you want to know a little about it, I sent this article to my dad, mom, and sister. It’s an inanutshell kind of article about fibrous dysplasia. Short and simple.)

But please believe me dear friends and family, the support you are giving me is something that I appreciate beyond words.

Updates and such to be continued…

Secondly No – I didn’t accidentally OD on pamidronte. I know it’s Wednesday. But we’re going to pretend this is a Three Thoughts Thursday, because that’s really all I got for you right now. (Plus, tomorrow has other plans. ;) )

1 // Giveaway tomorrow!!

2 // Pinterest. Nuff said. You can follow my pins (is that even how that works…?) or just check em out. I know Mrs. Lindsey Cotter found me somehow. The other three followers? One is a TC blogger, one is the saviour who sent me a new iPod, and one is myself. Total of 4. Balllller.

3 // Please answer poll below. Topic of upcoming post…

What do you think of Kinesio Tape?

View Results

Loading ... Loading ...

Again –  I don’t know how to put into words the appreciation I have for all the support you guys have given. I kind of feel like this…

 Bear hug. ^_^

I don’t know where this little animal love came from. Sorry little critters… not going back to being a vegetarian!

Take care, make sure to come back tomorrow for the giveaway, and remember: Life is too short for bad coffee.

-E

Category: Thoughts on a Thursday | Tags: , , ,
The Triathlon Rx | October 20, 2011
9 comments

One thought for this Thursday: Mayo Clinic

I’ve never been equally as inspired and comforted as I am terrified and disquieted by a single institution.

I have let myself become far too familiar with their Orthopedic Oncology department. I shouldn’t be able to tell you the first and last names of the three doctors there with that specialty, I shouldn’t have let myself get sucked in to the research they’ve done and the studies they’ve published, or get emotional over the testimonials from Mayo patients around the world. But I can, I did, and I did again.

Inspired, because they are a worldwide leader in medical care, research, and education. They have more than 56,000 scientists, physicians, students, and allied health staff.

Comforted, because they have a philosophy that the patient comes first, and they live by it. Reading their Value Statements is like sipping a pumpkin spice latte in front of a crackling fire. Because after reading different patients’ stories, I know I will be taken care of.

Terrified, because reading those same patients’ stories puts me in their shoes. Terrified because it makes me a patient who will be telling a story. Terrified because only good stories are turned into testimonials. Terrified because not all stories are fairy tails.

Disquieted, because I have never been in this situation before. Because I don’t know what the outcome will be. Because I feel selfish for being scared, when it could still be so much worse. Because I feel like I have no control over any single part of the situation. Because yeah, they change lives, but they can’t change things back to the way they used to be.

Sorry if this seems like a big downer post… and especially one that came out of nowhere. I tried for a long time to not talk about this at all on the blog, but I realized that writing about it and being honest is some of my best therapy. Especially when running is out. I’m not sure if I want sympathy or validation or just to simply get it out of my system… but what you get right now is pretty much just raw, unedited, me.

There’s still a lot up in the air about procedures and dates and first vs. second vs. third opinions. The only opinion I currently have is that I want to get it over and done with and move on. Right now I’m left with way too much free time to ponder the what ifs, the could bes, and the used to bes.

It is also effing with my sleeping schedule… which is why I’m writing this at 3am. Going to try to fall back asleep now.

-E

Category: Thoughts on a Thursday | Tags: , ,
The Triathlon Rx | October 6, 2011
6 comments

Thoughts on a Thursday // Marcaine + Cortisone Injection

Well… this is my way of “breaking the news” – part 1. There will definitely be more to come, so you can expect a lot more Medical Mondays. And probably Friday Confessionals.

Started my Thursday with this:

     

Top L: Disinfecting. Keepin’ it PG. Top R: Needle going into the hip joint. If you enlarge the photo, you can see the cointrast running through the joint. Bottom center: Closer up – doctor explaining the procedure. The two screws you see are two of these three. The third one is directly behind the upper one. Haha my first reaction was “um… isn’t there supposed to be one more in there?” The thing that looks like a little sperm swimming into the joint is actually the head of the needle. On the bone. ♪ Blue on Black ♪

Post injection, they wanted me to go for a test run. So I did. And because I was afraid my leg might fall off 4 miles from home, I brought my phone.

And in a moment of delirium… I made you a video. Fair warning – this might leave you feeling like you just watched the Blaire Witch Project. It made me dizzy!! This would have been much easier taken with a Go Pro HD Camera… just sayin. ;)

“Hey hunnies…”

Ohhhh wow.

If you’ve ever wondered what a “friend” blogger sounds like in real life? Here you go. This is me! Susan – do I actually sound like this in conversation? I [hopefully] promise I’m not that easily distracted in person. Example: (46 sec.) ”That’s a pretty tree.” Start a new sentence… (49 sec.) “That’s a pretty house!!” Hahah and I keep talking about how Minneapolis is really nice in the fall. (Note that I stated nothing about months December through March.) And how I’m going to get hit by a car.

Well I didn’t get hit by a car, and my leg didn’t fall off. Success! And I DID get a longer run than I thought … that’s what I get for leaving the Garmin at home! Good ol’ fashioned Gmaps Pedometer. 7.11 miles in 57 minutes.

The reason I haven’t brought any of this up yet (which you may or may not have caught in the video) is that I just don’t see any need to jump the gun. There are too many uncertainties right now (which surgical procedure, when the surgery will actually happen, the extent of the labral tear, etc.) to go into too much detail. But I also didn’t want to wait until the day before surgery, and then say… SURPRISE!! And I will say it has been hard to avoid the subject – it’s been on my mind. A lot!! Will keep everyone updated, but will hopefully also maintain the upbeat attitude of Dr.TriRunner going strong. :)

Reader Qs:

Have any of the readers out there ever had a labral tear? What was surgery and recovery like? Where was your tear? Where did you have surgery? While were talking about surgery – give me anything! What was the injury, what was the rehab, and how long was it before you were back to doin’ you?

-E

 

 

Category: Thoughts on a Thursday | Tags: , ,
The Triathlon Rx | August 29, 2011
7 comments

Medical Monday // training, racing, medicating

¡Buenos dias chiquitos! Before you leave today, don’t forget to enter the Vital Sox Compression Sleeve / Arm Warmer giveaway! Closes on WEDNESDAY.

Last week, one of my very best friends asked me about taking over the counter medications before a race. She traveled to the land of the Canuks to race Ironman Canada (which was YESTERDAY!!), and was curious if anything she might take would interfere with her race day. With the amount of time one commits to training for an iron distance race, I would definitely agree that you don’t want an OTC medication (or any medication for that matter) to be your downfall. If my race turns into a nightmare, I want it to be because I was undertrained, overtrained, unprepared for the course/weather/competition/whatever. I do NOT want it to be because I took too many Naproxen.

So of course, she innocently asks me a sports science question. And I get excited and respond with a novel. I’ve done some editing of our emails to make sure all bases are covered, and with that I think we’re ready to go!

There are two general categories of meds an athlete would take pre-race: those that cause some sort of anti-inflammatory reaction // and // those that don’t.

Most of you have probably heard the term NSAIDS – non-steroidal anti-inflammatory drugs. You don’t really need to remember the whole thing – just that the NSAID stands for anti-inflammatory. NSAIDS work to reduce inflammation in the body, help prevent blood clots (thin the blood), can reduce fevers, and blocks the COX enzymes (refrain from jokes – it stands for cyclooxygenase). The COX enzyme is responsible for prostaglandin synthesis, which in turn contributes to inflammation, pain, and fever. We could go into the science and chemistry, but I don’t think that’s what you’re here for. ;) Common medications in this category include:

  • Aspirin
  • Ibuprofin (Advil, Motrin, Midol, Nuprin)
  • Ketoprofen (Orudis-KT)
  • Naproxen Sodium (Naproxen, Aleve, Anaprox, Naprelan)
  • Celecoxib (generic of Celebrex. Rx only)

Then there is the category that does not cause an anti-inflammatory reaction. Because inflammation is such a big component of sports injuries… athletes are much less likely to take these on a whim. (Unless of course you were unaware that Tylenol and Advil won’t do the same things for you… in which case, keep on readin’.) ;) Again, a common [but incomplete] list would include:

  • Acetaminophen (Tylenol)
  • opiate agonists (Vicodin, morphine, codeine. Lets hope we’re talkin’ Rx only…)
  • local anesthetics

There are a few that get complicated because they’re multi-ingredient pain killers… Tylenol No. 3 (300 mg acetaminophen, 30 mg codeine), Tylox and Percocet (acetaminophen and oxycodone – different strength combinations), Combunox (400 mg ibuprofen, 5 mg oxycodone), Vicoprofen (200 mg ibuprofen, 7.5 mg hydrocodone). Unless you’re taking any of those or extra curious, I wont go into it. However, I will strongly advocate that everyone should discuss everything they’re taking with their doctor – prescription, OTC, vitamins, supplements, the isht you buy at GNC – everything. It might be fine to take one medication on it’s own, but if your doctor doesn’t know you’re also taking ­­­­_____, you could be talkin’ trouble.

In terms of the effect on performance… the two basic terms to know are ergogenic (performance enhancing) and ergolytic (performance inhibiting). While you will certainly find articles and published research touting ergogenic effects of particular medications, the research is not consistent.

[... One little tangent that I need to throw out there: If you’re not racing pro or collegiate, chances are you’ll never be drug tested. But for the love of God, the sport, and your own health, build a better engine. Don’t inject it with rocket fuel. (Unless you’re talking about Roctane, in which case I fully approve. Pineapple orange please.) Dopers suck. ...]

The biggest thing an everyday athlete would want to watch out for is the [unintentional] heavy-handed use of Aspirin or NSAIDS. As with almost everything in life, moderation is key. Without splitting atoms here, they can affect kidney function -> affects hydration and plasma volume -> dilutes electrolytes -> increases risk of hyponatremia. Keep the M[oderation]-word in mind, make sure you’re supplementing your electrolytes in addition to your fuel stores, and really you should be just fine. :)

So much for a short explanation. When I can actually apply the stuff I’ve learned, I get a little carried away. ;)

Reader Qs:

Do you typically pop an advil pre-race? Pre-training? Or are you one of those people that would rather pull a nail out of your foot with eyebrow tweezers than take medication for something? I am… or at least I used to be. After my less than pleasant encounter with poison ivy earlier this month, I think I’ve softened a bit. Prednisone might make you look like a blowfish, but it makes the itching go away. Thank you Gregor Mendel, Louis Pasteur, James Watson, Francis Crick, Alexander Fleming, and the many more who have contributed to modern medicine. :)

CONGRATULATIONS ON AN AMAZING IRONMAN CANADA FINISH C.C.!! CAN’T WAIT TO CATCH UP WITH YOU WHEN YOU GET HOME!

The end.

-E

Category: Medical Monday | Tags: ,
The Triathlon Rx | July 25, 2011
6 comments

Medical Monday // Electromyography

Alternate title… “The Day I Was Electrocuted.”

[Disclaimer - if you don't like needles, there is a needle picture coming! It's teeny tiny though. And no blood.]

(Marking nerve landmarks. Please ignore unfortunate/awkward position of the hand.) Last week I had the pleasure of being on the receiving end of an EMG, or Electromyography. That E_G sequence may look familiar to you, as in ECG (electrocardiogram), EEG (electroencephalogram), EKG (same as ECG). An electrocardiogram is for monitoring your heart, and an electroencephalogram for picking up electrical activity of the brain. (Question for you Dr. Greg or anyone else who can answer… why is an EMG -graphy, and ECG and EEG are -gram?)

So then, what is an EMG?

An EMG, or electromyography, is a diagnostic test used to evaluate the health and functioning of motor neurons and the muscles they stimulate. You can use electrodes placed on the surface of the skin to detect or transmit electrical signals, and/or you can do a needle EMG, in which case a needle is placed directly into the muscle and records electrical activity. I was fortunate enough to do BOTH, because really, who doesn’t want to be shocked and skewered by their doctor?

     

The electrodes were moved around as he shocked different nerves. A made-me-jump shock at my elbow felt like a finger tap on the medial side of my palm. Hmmmm….)

Your doctor may order an EMG if you are experiencing tingling, numbness, loss of motor control, weakness, pain, or cramping. An EMG may be used for preliminary testing for muscular dystrophy, polymyositis, myasthenia gravis, carpal tunnel syndrome, amyotrophic lateral sclerosis or a herniated disk in the spine. Putting my sarcasm aside for a minute – I am very thankful that I have none of these are my diagnosis, and honestly and deeply do appreciate my health.

A neurologist typically reads the graphs/charts created during the EMG, and will go over it with your doctor, who will go over it with YOU. There are really only two outcomes: normal tells you you’re fine, but doesn’t solve the question/issue you were trying to solve by doing an EMG in the first place… and abnormal tells you you have more testing to do.

And that, my friends, is more than I’m sure you ever wanted to know about electromyography. :)

(Needle EMG! It was honestly the size of an acupuncture needle… teeny!) If you’re wondering why I was getting an EMG in the first place, it’s a long story that I’m about to make really short. A couple Sundays ago, I was in the middle of a pull set (in the pool) when I realized water was flooding through my left hand. No matter how hard I focused on it, I couldn’t keep the fingers on my left hand together. I was only about 1,000m into the workout, and it was a pretty easy swim to begin with, so I was reasonably frustrated and confused. (Imagine trying to kayak with a paddle full of holes!!) No pain, just weakness and lack of motor control. If you have ever come in from a winter run and you can’t coax your fingers to turn a door key or untie a shoelace, that’s exactly how my fingers felt (/feel). Fortunately, I already had an appointment scheduled with my sports med doc anyways for later that week, so I was able to get in and get her (doctor’s) opinion relatively quickly.

However, the issue is still not resolved, as I haven’t been able to successfully swim more than 1000m before losing strength in my left hand. (I know – cry me a river. But even if you don’t love swimming, you’d probably miss it too if you’re used to swimming on a regular schedule!) It’s mostly affecting the extensors and the pinky and ring finger, which to me sounds like an impinged ulnar nerve. The person reading the EMG had the same consensus, and now, I think, it’s just a waiting game.

Reader Qs:

Have you ever had an EMG, ECG, or EEG? If so, why was it ordered, and what did it show?

See … Mondays aren’t really so bad. You get to learn something new, and you don’t even need to sit through a whole semester of PHAR 5201! Make the start of the week a good one!

-E

Category: Medical Monday | Tags: , , , ,
« Older Entries