Thursday, July 7, 2011

It's been 5 months already?!

I had surgery on my ankle on Feb. 7, 2011 (removal of two bone spurs plus repairs to some cartilege damage that my surgeon found while he was in there-- eventually I'll go back and post details, but today is not that day). I've just realized: that was five months ago today. Five months! Shouldn't it be totally healed by now?!  I was on crutches, completely non-weight-bearing for 6 weeks, then went to PT for another 6 weeks. Jump ahead to last weekend, and I was able to walk 7+ miles. This is good progress, I know. But the ankle still gets sore randomly (like tonight-- major limping due to a sharp pain, no idea why) and is stiff for the first few steps after resting/sitting, until it gets loosened up.

My surgeon says this is not uncommon with ankle surgeries. "Ankles just always take longer to heal than it seems they should," he says. So far, my progress is looking good. I've put running out of my head until next year (if it ever becomes possible again at all-depending on the success of that cartilege repair technique), but I did ask when he thought running might become possible again. Maybe this fall he says. Interesting. I'll just keep the "after Jan 1" date in my head to keep my sanity. No pushing this particular envelope.

Besides, I suppose there will be no running until there is no more pain, and pain-free I am not. Ah well. I will do my best to remain patient, because really, what other choice do I have?

Friday, January 7, 2011

More waiting

Well it was fun while it lasted -- the 2 weeks of pain free running, that is. That's as long as the steroid shot got me. So on to the final, surgical option. I've got an appointment next week with the person who will potentially actually do the surgery. And I've still got an appointment on Feb. 3 with the internationally renowned local foot and ankle surgeon (who is actually retired from surgery) just for a consulation. If everyone agrees that surgery is at least worth a shot, then we'll move on with that hopefully soon after that Feb. 3 appointment.

I'm getting impatient, and have thought about just going ahead without the Feb. 3 consult, but I was reminded by my sports med dr that given his reputation, and given the seriousness of a surgery, it's worth waiting just a little longer to get this guy's opinon. So I'm waiting. Not terribly patiently, but I'm waiting.

In the meantime, I learned that there's a new minimalist running store that just recently opened in Bellevue, called, what else, Born to Run. I was particularly pleased to get to see in person and try on some of the Terra Plana VivoBarefoot shoes that I've been eyeing online. I hear that they'll have more VFFs coming in soon. I also hear there's talk of opening a second store in Seattle, but apparently that's still in the works. I'd wondered before how a minimalist-only shoe store would do around here....I guess we'll find out!  They gave me 10% of coupons to give to my friends so I'll be happy to share them with anyone who wants one.

Monday, December 13, 2010

Game Play

My second run (4 miles) last week was great! I was just running comfortably no worries about pace or anything else. The ankle was quiet, and yes, it was really fantastic to remember what it feels like to run with nothing hurting. I ended up running 8:30-ish minute miles. Speedy for me! So that's the pace that feels comfortable when nothing hurts. Good to know!

Tonight's run was not as good. I planned 5.8 miles, but had to stop running at about 3.8. I ran a little after that but ended up walking the last mile in. I didn't get the usual sharp pain from the ankle, but something a little more "muted" if that makes any sense. It still hurt enough to let me know I needed to stop, but it just wasn't the same intensity as usual.

I was particularly sad to have it end because I'd been pacing two guys behind me. They'd fallen behind me at one point, but eventually seemed to be making it a point to catch up, and then keep up, with me. So I hung steady for a while. Then I very slowly started picking up the pace....and after a while left them behind with a short sprint. I slowed and was going to let them catch up and start again, but my run didn't last much longer before I had to call it done. Ah well. It was fun while it lasted.

At least now, at home, my foot is completely comfortable. No lingering ankle pain/limping for the rest of the evening. That's something.

Tuesday, December 7, 2010

First run on my steroid shot

I was a like a kid on Christmas. I was awake at 4am this morning (not unusual) and couldn't get back to sleep (VERY unusual). I think I was anxious to give this steroid shot a try.  I went out to Discovery Park for the first time (yes I'm embarrassed that I've been running in Seattle for 14 years, and just now made it out to the Discovery Park loop), and ran 3.5 miles. I figured I'd try to break some of the mental patterns I have on my usual running routes while trying to break this pain pattern. The ankle felt comfortable, and was not painful at all on the downhills (which is signficiant). I had a little discomfort (not pain) toward the end. It seemed more along the lines of the "you might have some pain for a day or two caused by the shot" than by my usual ankle issues.

Unfortunately on the drive home, something did end up pinching in my ankle wrong (as often happens when I drive after a run). Drag. This pinching tends to happen when I have to raise my toes immediately after running, as one does to press the gas pedal (or to climb the steps to my house).

Last night when trying out some stretching, I had no soreness. Usually I stretch that calf to the point of pain. Last night I could stretch it as far as possible (which is still less than my left foot, as the right has more limited range of motion), but with no pain whatsoever. So that's promising.

I don't think I asked the dr how long it should take for the full antiinflammatory/pain relief effects to kick in, but since he told me I might have some pain at the injection site for a day or two, I figured it might take a few days (quick web search says sometimes a week or two). Would I have loved 100% relief today? Well yeah, duh. Did I expect it? Not even I am that optimistic. One step at a time.

Monday, December 6, 2010

This is your ankle on steroids

Back in June, I had my ankle X-rayed and was told that yes there was a bone spur causing "anterior ankle impingement," and perhaps an injection into the ankle could help atrophy some of the scar tissue around the spur and thus relieve my pain. At the time, I thought I had a mostly pristine ankle, and the injection proposed made me nervous. Nothing I'd learned from my research confirmed that the stuff to be injected  was some magic potion that could atrophy scar tissue without also atrophying the healthy tissue in there. Afraid that I might cause more harm than good, I decided to wait on the shot.

Several months, two doctors, and an MRI later, I was essentially told the same thing. Only this time I was ready for it. First, the news came from a doctor I trust. Second, because of the MRI, I now have a fuller picture of the situation. I now know that my ankle joint is hardly pristine. It's already mussed up in there with osteoarthritis. So my fear that they could put something in my ankle that might damage it-- well, it's already damaged so I figure there's no harm in trying the steroid injection.

Essentially this is the first step before potentially moving toward surgery. It is possible that the steroid breaks the cycle of pain/inflammation, and allows everything in there to calm down enough that the pain goes away forever. Yes, forever. (I'm praying for this option and invite anyone willing to do the same!!)  Or, the pain could go away and return in a matter of months, simply reaffirming that we're looking at the right spot. Anyway, if the pain returns, the surgeon says yes, surgery is a possibility. Yes, it could fix everything. Or it could not. It's hard to say, but the specificitiy of the pain does bode well for the efficacy of surgery. But the first step, before doing surgery is to try a steroid injection.

I'm cautiously optimistic. At the very least it suggests that I should be able to run without pain for some period of time. (I'll test that theory tomorrow.) It's been a long time, so I'm pretty excited about the prospect. If this gives me a chunk of time without ankle issues, I also expect to get a not insignificant amount of grief from my husband and my running partner, both of whom thought I should have gotten the shot when it was first suggested six months ago. Oh well. Getting some mental buy-in to the whole process should only make things go more smoothly than had I done it while thinking that I was doing something harmful. We will see what happens in the coming days/weeks.

Sunday, November 28, 2010

"Run, Walk or Crawl" - Did I really mean it?

I finished the Seattle half today (wearing my Bikilas). I went into it knowing that I wouldn't be able to run the whole thing (thanks to ongoing ankle pain and related lack of training), but planning simply to run as far as I could, and to run/walk the rest (or in a worst case, to call my husband to come get me if my ankle wouldn't tolerate even that). The primary directive was simply to not hurt anything. I was hoping for something along the lines of a good walk/run combo a la my performance at the Bellingham Bay half marathon. Instead, I ended up running 4.5 miles, run/walking the next 2 miles, and then largely walking the rest (I ran less than a quarter of each of the last 6 miles).

I once felt some pain while walking, and wondered if I might need to call Wayne to come get me, but that quickly resolved. Thus I was left with a few miles of wondering -- should I just call him anyway? Did I really want to walk 5 more miles? What was the point if I couldn't run the race as I'd actually wanted to do?

I'm not sure I entirely know what the point was. But I decided that I would finish, even if it meant walking, because (1) I'd taken the trouble to start, (2) I'd jokingly told other people leading up to this race "hey, I can walk 13.1 miles if I have to", and (3) because I've been out there cheering on runners and walkers in the past, and one of the chants I'd yell to the walkers was "Run, walk, or crawl! One foot in front of the other!!"  So if I didn't think it was worth it for them to give up the race simply because they were walking, I guess that meant I shouldn't either.

I am sure there was some value in simply not giving up...though I'll see how that is revealed to me as I rethink the race in the coming days. I told myself that I should look at it as a reflection of my refusal to give up on being active and strong even as my running feels like it's slipping away from me. So there's something just in that I suppose.

Still, I can't say that I'm not disappointed that I couldn't run further today. But, I'll try not let it get me down. There are certainly worse ways to spend a morning than meeting up with friends, spending some time being active outdoors in chilly (but dry!) weather, being inspired by other runners and cheered on by my husband and a friend (with some pretty nifty spiffy signage!), and going out for breakfast after. Nope, definitely not a bad way to start a day.

Saturday, November 27, 2010

What Harley has taught me about play

I've been reading a lot lately about the importance not just of exercise, but of rethinking our largely sedentary lifestyles on a larger scale. I've been feeling the effects of being in a job(s) where I sit in front of a computer most days, and am sensing that some change needs to be made. I'm not talking about a recommitment to getting daily exercise (that's an ongoing effort), but a change in terms of rethinking how I do (or don't) move my body through the world each day.

In Change Your Body, Change the World, Frank Forencich argues that part of the problem is the label we put on exercise. What we really need is not "exercise" but more physical movement.

"The problem with exercise becomes apparent as soon as we begin to describe it. That is, exercise consists of doing abstracted movements in a stereotyped, repetitive pattern. In essence, exercise is a specialization extracted from a larger whole, an activity taken out of its natural context...The main problem with exercise is that it's all about sets, reps and mileage: just keep grinding it out until the clock runs out or your trainer tells you to stop. This, of course, is a recipe for physical monotony. And physical monotony, like any kind of repetitive behavior, tends to be hard on both the mind and tissue...
Exercise also fails because stereotyped reps tend to drive out play. The contrast is clear: exercise is about repeitition of known patterns while play is about exploration and discovery. Exercise is about enduring unpleasant sesation; play is about finding delight in diverse movement forms. Exercise is about repeating the known; play is about extending into the unknown. Exercise requires external motivation to maintain participation; play is inherently rewarding and self-reinforcing." (pp. 54-55)

This has come to life for me when playing with Harley. Our little miss Harley loves nothing in this world more than playtime. She frequently sits at my office door, pleading nonstop with her sweet little cries until I finally get up and indulge her in some play. She is an acrobat at heart, and loves jumping and flinging herself into all sorts of contortions to "catch" the little stuffed "mouse" hanging off the springy end of her stick toy. We go down in the basement, where there's plenty of soft spots to land (important since she often gets so excited she doesn't stick the landing), and Harley starts jumping....on the bed, off the bed doing cartwheels, backflips and less-than-graceful kitten jumps that seem impossibly high for her little body. She will go and go until she literally falls over with fatigue. But give her just a few minutes' rest, and she's right back at it. She just cannot resist that fuzzy excuse to jump!

But as much as she loves to jump, and as much as I'm sure she wishes I would spend most of my day waving the springy toy around for her, she never, ever goes jumping around down there on her own--even though she certainly could. She has to have the springy toy and somene flinging it around for her, to make it fun and therefore of interest. And it's not that she prefers "fun" over "exercise." She simply does not do "exercise" at all -- ever -- in the absence of play.
So I've giving thought to my own ideas about "exercise." For as many years as I ran on a treadmill, I've found no joy in it lately. I'd rather be cold and wet and run outside (preferably running newer, less familiar routes), than warm and dry on a treadmill. There was a time and place for the magic treadmill+TV combo in my life, but right now, I'm needing something different. Even in my cycling life, I've decided to spend money on a cold weather riding jacket rather than a trainer that would let me use my own bike as a stationary bike indoors. (We'll see if I put it to good use this winter, but it feels like a choice in the right direction, in any case.)

This all goes along with the whole natural movement/Cross Fit idea that we don't need to spend time in a gym so much as we need to spend time "playing" outdoors. It's compelling to me right now and it's informing some of the smaller decisions I'm making in trying to incorporate more movement in my life (walking to run some errands instead of seeing those walks as taking "too much time." What am I in such a hurry to get back home for? So I can get back to my chair, back to my desk, back to my computer, back to sitting, just like I've been doing all day?). I've also looked into adjustable desks so that I can spend some of my day standing rather than sitting, for example. But in addition to starting with these small steps, I'm also starting to look at how I might change the bigger picture and trade a largely sedentary daily life (even one in which I get regular exercise) for something that allows me to move more. To be healthier? Sure. To lose a few pounds? Maybe. But mostly just to add some more quality to my everyday freelancer life.

Thursday, October 21, 2010

And the MRI says...

I finally had an MRI done on my ankle. I have a bone spur that may be causing an impingement at the front of my ankle (this was what was suspected based on my X-ray). However, it also shows osteoarthritis of the ankle (talonavicular joint) likely a result of a 1988 ankle break/dislocation, i.e., posttraumatic osteoarthritis.

If the pain I'm experiencing is due to the impingement, it may be possible to do surgery to remove the bone spur and clean that area out, thus improving range of motion and relieving my pain. If the pain is due to the OA, then there's not so much that can be done medically. I simply have to obey my pain when I run. Considering that I can run anywhere between 3 and 6 miles without significant pain, this is not terrible news. I can still run. Considering that I want to run longer (marathon or half marathon) distances, this is not great news. I cannot run very long.

I've got appointments with two surgeons to review the MRI results and discuss my options. I'm not sure how or if they can pinpoint the cause of the pain, but I'll see what they say and go from there.

Monday, September 27, 2010

Bellingham Bay Half: First Long Race in Vibrams

Yesterday I ran my first half since The Vancouver Marathon (i.e., the day I broke my foot), and my first half in the Vibrams (Bikilas with Injinji socks). I hadn't really properly trained for this event, but wanted to at least try to run it with my friend Melissa, who was running her first half. Having only "trained" (and I mean that in the loosest possible definition of the word) up to 8 miles, I figured that in a worst-case scenario, I could run 8 and then walk the remaining 5 if my ankle wouldn't cooperate beyond that. As it turned out, the ankle was mostly cooperative through mile 10. After that I slowed the pace and incorporated some walking so I could finish.

I'd been so focused on deciding whether or not I was actually going to surprise Melissa and do the run with her  (I signed up two days before), and then on being mentally prepared to bail late in the race if the ankle wouldn't hold up, that it didn't really occur to me until after I actually finished that this was my first long-distance race since the marathon. I finished in 2:08:51, which isn't all that pretty in terms of my most recent half times (1:58 and 2:04), but it wasn't all that bad considering that I hadn't really trained for it (sporadic training runs over the past month, with barely any running the past two weeks) and that I'm coming off a year of dealing with a significant injury and making a complete change in my running technique.

Still I think this proves that the ankle is making progress, that my change in running technique seems to be working for me, and that once this ankle thing is resolved, I am going to be able to run like the wind! I felt great in every way except my foot. At mile 11 or so, I was thinking, that my breathing and speed were feeling really great (during the portions when I could run) if I could just not have to be babysitting my ankle.

Today my calves are remininding me that they're there (hello calves, yes, I hear you), and you really don't want to ask me to do anything quickly if I'm not already standing up (everything is setting up while I sit), but overall I feel good, and even better, I'm feeling pretty hopeful about my running future. I'm thinking another Seattle Half this fall....

Monday, May 31, 2010

Larabars Fuel 62-mile Ride

In spite of the drizzly weather, we got out for a 62 mile bike ride yesterday, out to Tiger Mountain and back. The uphill on Tiger is not so steep, but steady and fairly long, but quite doable -- and the downhill is totally worth the climb. What a fun descent! I took apricots and nuts, as well as a couple of Larabars on this ride, and was reminded just how much I love LĂ„RABARs. I love that they have 5-6 foods as ingredients and nothing else. I think I'll try making a homemade version, but these are going to be my go-to barin the meantime. This time I tried Cinnamon Roll and Ginger Snap flavors. The latter was a little heavy on the ginger for my taste, but the Cinnamon Roll was great (ingredients: ■Dates ■Walnuts ■Almonds ■Raisins ■Cashews ■Cinnamon). I'm looking forward to working my way through all the flavors.

Unfortunately I haven't been able to give my Bikilas much of a trial, as I've decided to obey the pain in my ankle and lay off for a little while. I did a few barefoot runs and stopped at the very first sign of the ankle pain, which happens at about 1 to 1.5 miles. I can run 4-5 before it really gives me problems, but I figured I'd try backing off on the running for a few weeks and focus on cycling instead, particuarly since I've been eyeing the upcoming June 20 Livestrong Challenge century.

I finally made an appointment to see my podiatrist again. Last time he couldn't/wouldn't diagnose this ankle problem because all he could see was my PF (I think he thought the ankle issue would go away with the PF, but it didn't). So I'd like to (1) see if he can diagnose it -- possibly with the MRI he mentioned, and (2) get a "prescription" to see a PT so I can work with someone to get it fixed (I need the prescription if I want my insurance to cover it). My attempts at strengthenging/barefooting/reducing mileage have helped, but haven't made it go away -- and it happens both on the bike and the running. Time to look for more help!

Look at all those rest days over the past two weeks! Eeks, well, I suppose I meant it when I said I'd try to give the ankle a break.

5/30 (Sun) Cycling 62 mi
5/28-29 --
5/27 (Thu) Weight training, 1 mile running (Bikilas)
5/25-26 --
5/24 (Mon) Cycling 52.5 mi.
5/23 (Sun) Run 2.8 mi. (Bikilas)
5/22 (Sat) Cycling 12 mi.
5/21 --
5/20 (Thu) Weight training,
5/19 Run 1.2 mi. barefoot
5/17-18 --
5/16 Beat the Bridge Run 5 mi. (VFF Flows)