Cut Me Mick

     

      For those of you that don't remember those words, they were spoken by Rocky to his trainer, when his eye was so swollen shut he couldn't see and the only way for him to continue in the fight was to have the trainer cut him to release the pressure and allow him to see.  Well it may not be my eye and this may not be a boxing match, but it is what I have to do if I want to continue running.

     For those of you that have been following along, today was my follow up doctor visit to review my MRI results along with my x-rays, and what I hoped would not be the case, was the case.  The MRI shows a possible labral tear of the cartilage that separates the ball from the socket of my hip joint.  I say possible because no doctor is every going to deal in absolutes until he actually is cutting me open and seeing it for himself, but the evidence seemed pretty convincing.  

     Well, how to we fix it you ask?  We cut me open of course!  Ok, I will stop being overly dramatic, since it is only a one day out patient, arthroscopic procedure where he will cut three small incisions in my hip and thigh to fix the issue.  What I will not exaggerate about is the recovery time, holy shit!  I will have to be off of work for a week to ten days, followed by trying to maneuver around on crutches for three to four weeks.  After those initial ten days I have roughly three months of physical therapy and an estimated time of six months before I can return to running regularly pain free.  Chances are it will be at least year or so before I can attempt another marathon, if ever.  

     Those that I have talked to about this have said I seem rather positive about the whole thing, well what can I say, this has really fucked up a lot of plans and goals I have set for myself, but it is what it is, right?  I mean I would be lying if I said I wasn't completely devastated, but feeling that way and throwing a tantrum like a four year old won't do me a bit of good, so moving on.  Now I have to figure out when is the earliest I can get in to have the surgery done, and based on work related commitments, that looks more like late August or early September at best.

     The other issue I have due to today's news, is what to do with my Detroit Marathon registration.  I cannot get a refund and other than just losing $75 and not showing up for the race, I could do a transfer to someone else.  I am going to do a little research on transfers and maybe just donate my registration fee to someone else who could use it.  So stay tuned for that!  

My MRI Pulp Fiction Experience

     I have to say that yesterday was a bit of an experience for me.  I haven't ever had any major medical issues that required anything of this magnitude when it comes to testing.  I had my first ever MRI yesterday, and not knowing what to expect I went in filled with more anxiety than I usually do.  My appointment was at 3:00 so I headed over to that area of town to grab a bite to eat and walk around the mall to kill some time before all the festivities began.  

     I arrived thirty minutes early to get checked in and only had to wait about fifteen minutes before they called me back.  The order of the day was going to be started with getting injected with a numbing agent, MRI contrast dye and a steroid that was ordered by my doctor, followed by a forty five minute MRI session as the nurse explained to me.  She first took me back to get changed for the procedure, which I had brought a pair of shorts to wear, but my anxiety quickly skyrocketed when she told me to strip down to just my socks and put on a medical gown.  Despite feeling truly uncomfortable in the situation, there was something very freeing about hanging in the breeze.  

     After I changed I was introduced to the MRI tech who went over my two page questioner, which I stated I was claustrophobic and had tattoos.  The tattoos could have been an issue because some inks contain metal which can feel a burning sensation and can irritate a patient during the MRI, I however had no issues with this during mine.  She showed me the "open" MRI machine she would be using and actually loaded me into the machine for a trial run to make sure I would be ok.  I was fine and didn't feel boxed in, but my face was about two inches from the machine, so it was a little unnerving. 

     Once she let me out, I was headed to another room to get the injections done.  I climbed aboard the x-ray table where the nurse positioned my leg and pull my gown up to the point I was very uncomfortable.  Now the whole time I was there the nurse and the MRI tech was so nice and accommodating, but at this point the nurse was explaining the injection procedure and by the time I was done I felt like the doctor was going to come in and go all John Travolta in Pulp Fiction on me.  As the doctor began to inject the needle I was prepping myself for a painful stabbing by clenching my hands and squinting my eyes as tight as I could.  Wouldn't you know, it wasn't shit to deal with.  I have had more pain getting my blood drawn than what I went through here.  Now for the cool part, I mentioned I was on an x-ray table, well he had a live x-ray shot of my hip on the screen so he could see where he was guiding the needle.  Once I realized the pain wasn't anything to deal with I looked at the screen to see this long needle injected into my hip joint.  He explained that I would feel pressure in the joint once he pumped all the drugs and the dye in, and sure as shit, it felt like someone was putting slight pressure on me.

     Now, for the MRI portion things didn't go quite as smooth as the injections did.  The tech got me all loaded into the machine, cranked up some '90s rock on the headphones for me and we began the scans.  After the first two scans, lasting in total of about fifteen minutes, she came in to make changes to the machine because she said, and I quote "you are to skinny and I have to change the machine to get a better picture."  It still is funny to hear someone utter those words to a person who use to be 317 pounds, but digress.  The change to the machine took about five minutes or so before I had to climb back onto the table and start the entire procedure over again.  From this point on things were going smoothly and I thought I was done when the tech said she was coming in, but I was wrong.  She told me that the last two scans she was unable to get good images and asked me if I would try the other machine, you know the tube that feels like your in a fucking coffin.  She said it would be ten minutes at the most, I said what the hell I can handle it, I think.  Thankfully she put me in feet first so my head was still sticking out a little, but man it felt tight in there.  We got started, and after the first scan I was doing pretty good, so she quickly moved on to the last scan.  I don't know what happened, but as soon as she said we were done and she was coming in to get me, my anxiety level shot through the roof and I felt trapped.  If she would have taken five seconds longer I think I would have had a full fledged freak out.

     I should have the results in a few days and I meet with my doctor for a follow up on the results next week.  I was given a copy of the images to look at, but I don't know what the hell I am suppose to be looking for, but here are some examples of the scans.  If I am correct the really white areas are the cartilage lining the hip joint.  I'll will have to wait till next week to be enlightened on what I am seeing here. 

It's There In Black & White...Sort Of

   It certainly been an emotional roller coast trying to figure out the how, what, where and why I was having main in my groin/hip area.  I tried to rack my brain figuring this out and little did I know, the cause of all of this has been there probably since I was born.

     Wednesday I had my first visit with my orthopedic surgeon to get some answers.  Overall I would say the visit went very well and I felt completely comfortable with him.  When I arrived I was first sent to get x-rays of my hip.  When that was finished I made my way to the waiting area before his nurse came and got me for all the usual questions one gets asked at the start of a doctors visit.  When the doc came in he asked me a few questions about the background of my injury and then proceeded to perform a physical exam.  He twisted, pushed and pulled on my leg and hip spouting of a bunch of medical jargon for his assistant to write down.

     When he was finished he pulled out his iPad to show me the results of my x-rays.  What they show was some over growth of bone which amounts to, using a layman's term, a bump on the ball of the hip joint on top of the femur.  How he explained it to me is there is cartilage lining the hip joint socket, called the labrum, that the ball on top of the femur rides on.  When use my leg in a running stride type motion that bump rubs up against the cartilage and can cause irritation and / or a tear in that cartilage.  So needless to say I got some answers, but it only raised more questions for me and my doctor.

     So where do I go from here, well the next step is to find out if there is truly any damage to the cartilage itself, or any other factors that cannot be seen on an x-ray.  Next up is the super expensive MRI next week, with a follow up visit the week after to go over the results.  I would guess that after the MRI, doc will have an idea if this requires surgery or something else.  I know I have my assumptions as to the answer to that question, but no need to put the cart before the horse.

Taking It To The Next Level

     Just wanted to throw out a quick update on my injury and the road to recovery.  Last week, Alisha, my physical therapist asked me to take a complete week off from all activity and we would reevaluate on Wednesday.  During my rest I put myself on an ibuprofen regimen and a icing routine.  Slowly throughout the week the pain started to subside and I was starting to get a positive feeling that this may be all I needed, that is till Wednesday.

     I woke up Wednesday and the pain and aching had returned in full force and believe it or not all I could do was smile, shake my head and laugh.  I sent Alisha an email letting her know of my progress and regress for the week.  She felt it was time to take it to the next level and see a specialist.  I really had no idea what to do or who to see on, so Alisha recommended a doctor that is top notch in his field here in Toledo.  Alisha has been so great through my previous injury recovery and now this situation that I fully trust her opinion and who she recommends I see.  She got me his contact info and I called for an appointment.     This coming Wednesday I'll be having my initial evaluation and an x-ray, so hopefully I'll have an answer to my problem or at the very least have it narrowed down to a short list of possible issues.

     If you wonder how I am able to keep my spirits up during this situation, well its been a little rough but Jedi has been keeping me entertained!

   
     I am anxious to see what he has to say, but I fear that this my drag on for a couple of weeks before, one, I have a diagnosis, and two, know if I have to have surgery or not.  So for now, the goal is to get healthy enough to run again, while I hope and pray that I'll be able to run the Detroit Marathon in three and a half months!

What Could It Be?

     So after last Sunday's run I contacted my physical therapist and gave her the bad news of how the run went.  She pretty much said what I new she would say and what I was thinking as I walked/limped back home, "you should have rested today and not pushed yourself".  She wanted me to rest on Monday and Tuesday, then attempt an easy 2 mile run on Wednesday.  

     I woke up on Wednesday and my hip joint area was aching a little bit.  I thought about not attempting the two miles, but I stretched out and went anyway.  I kept slow, around a 10 min pace and did fairly well, but I would get an occasional twinge of aching type pain.  Nothing to make me stop or want to stop, just reminding me that its there.  She wanted me to stop at the end of the first mile and do a few light stretches, so when I hit mile one I stopped and did the stretches and turned tail and headed for home.  At mile 1.66, that same twinge of aching type pain with an occasional sharper pain (nothing intense) would come and go much more frequently till I finished the full two miles.  When I was done, the aching pain hung around and lingered for awhile afterwards.  

     I contacted my PT and she decided it would be best if I came in for another session that afternoon.  She seemed concerned that the pain was coming on sooner and sooner with each run.  So after a lot of questions and the usual pushing, pulling and twisting the theory changed from a muscle issue to possibly being a tear to the hip joint cartilage know as the acetabular labrum or labral tear.  Basically from what I gathered on the Internet, that this is the cartilage that separates the ball from the socket in the hip join.  

     Obviously my PT wasn't making a diagnosis because the only true why to know if it is a labral tear is to have an expensive MRI, but based on the symptoms I have described to her she thought this to have a good probability.  According to her and what I read online, there are two main ways of treating this.  First is a non surgical option, which means a lot of physical therapy and strength training to strengthen the muscles around the hip to better support it and minimize the onset of pain.  The other is surgery which then would be followed by lots of physical therapy and no guarantee that the pain will end and running can continue.

     So where do I go from here?  Well because she is on the fence about it being a labral tear we decided for me to take one week off from all activities and completely rest it.  It was recommended, but not prescribed to take whatever anti inflammatory I am comfortable with taking and icing the area several times a day.  Next Wednesday we will talk and reevaluate our options.

     Part of me really wants to pay the money to have the MRI done just so I know for sure what I am dealing with, but the other part of me knows I don't really have the cash to pay for a test that could, even with my insurance, cost me 1-2 thousand dollars.  Mostly though, this is turning into a real test for my patience.  This could be a very small blip on my running life, but damn it, when you are going through it, it feels like an eternity.       

Where Is The Nearest Wall

     Man I can't tell how great things are going right now.  I have been in such a great mood and run all kinds of miles and I have a dozen races on the schedule coming up, life couldn't be better with my running right now..........is what I really want to say right now, however this couldn't be further from the truth.  

     I visited my physical therapist on Wednesday to get my leg checked out.  She went through a series of exercises along with a lot of stretching, twisting and pulling to try and loosen things up.  I was instructed to attempt a 3 mile run with a quick stretching break at the end of each mile.  Thursday's run went pretty well and Saturday's run went even better which gave me the confidence to head out for another run this morning.  Well that is what I get for thinking I know what is best, because I didn't even make it to a mile and a half before pain set in and a short mile later I decided to shut it down and walk the last half mile home.

     I started to think of all my goals I set for this year and started to feel so defeated and depressed.  When I developed my knee injury, I thought I hit the ultra low point, but I think having come back from an injury to have another one pop up so quickly really can send you to a new low.  I really felt like just beating my head against the wall, because at the end of the day, I really don't care about my time goals or PRs, I just want to get back to a regular running schedule.  I got into this to lose weight and now I need it to maintain my weight so that is why I think I take it so hard when I can't run.   

Yeah, this is how I feel right now dealing with nagging injuries.

      So I went back and looked at my goals I set for myself for this year and even though I actually have accomplished two of those goals, neither of which was a running goal.  Here is the list of goals for the year:

Get back to regular running

2015 or more total miles for the year

Run a trail race

37 miles on my 37th birthday

Complete an Ultra Marathon

Complete the Detroit Marathon

Hit my goal weight of 173 lbs

Maintain my weight within the range of 168 - 178

Try more fruits & vegetables

     I hit my weight goal, tried more fruits & vegetables and I could even say I have maintained my weight within range, but I won't count that one till the end of the year.  With the exception of one of them the rest are being thrown out the window because I think I am trying to hard to do to much to soon.  Getting back to regular running is my first and only goal, because if I can't do that, the Detroit marathon isn't going to happen, and I really want to do that one and run with my friends.  I am going to rest tomorrow and talk to my PT again and see where I go from here.

New Injury, Just Before Marathon Training Begins

     I so want to be writing tonight on how my 10K at Kelleys Island went today, but I am not for two very different reasons.  The first and less important one is I had a really long day at work followed up by a long evening at Ohio Bike Week.  It was the last night for all the major festivities and the band Buckcherry was the evenings final entertainment.  When we got home around 11:30 the pups were wide awake so we stayed up to play with them and by the time we crawled in bed it was close to 1:30am.  Based on how tired I felt I decided I really didn't want to get up early and pay to go run 6.2 miles when I could sleep in and run 6.2 for free.  Well it was a good thing I made that decision because I would have had the worst race of my life and possibly a DNF if I had run. 

     So let me back track for a minute, on Wednesday I went out for my long run when I was about 4 miles in I started developing some pain in my upper outer thigh, just below my hip and the inside of my leg around my groin area.  The pain slowly got worse to the point I even stopped to stretch it out.  I finished the run and emailed Alisha, my PT about my pain.  She instructed me to ice and stretch and rest a couple of days, so I followed her instruction and even took one more days rest than she suggested.  I woke up this morning feeling pretty good and rested and decided to head out for a 6 mile run, which turned out to be a very bad and stubborn decision!  Two and three quarter miles in I felt a slight pain come back and by the time I hit mile three I needed to stop and stretch it out.

     Since this was an out and back run, I turned around and started a slow jog back thinking a super slow pace would help, but it really didn't.  At 3.5 miles I decided to shut it down and walk the rest of the way home.  It was the stubborn for me to think I could just go out a few days after an injury and just run six miles like nothing was wrong, but I did.  Needless to say I was quite disappointed and feeling pretty deflated.  Now you can see why I am glad I didn't head out to the race today.

     Now it would be easy for me to sit here and ramble on about how this sucks and am I ever going to return to some normalcy and injury free running, but I won't do that to you all.  I am going to speak with my PT and see where I go from here.

     Out of the darkness there is at least a little light to be positive about.  On Wednesday I had my first weigh-in in two or three weeks and I have been having success with my maintenance.  Weight has been holding steady just below my goal weight of 173 pounds.