This blog is like a "choose your own adventure" book; you get to decide. One sentence, or a full diatribe!
Long story short: I haven't really ran (save a few short intervals) in over 3 months, and I'm not sure when I will be allowed to run again.
Long story long... well, pull up a chair.
Per my most recent blog, my diagnosis in early August was a stress reaction in my right hip + a small tear in the labrum. My sports med doctor (Dr. Natalie) decided to treat the pain as if it were coming from the stress reaction, and told me to take a few weeks off from running. Well, a few weeks passed... and a few more... and things still weren't feeling better. Thankfully school started back up again at the end of August, so my mind was busy with my new position. Fall sports started in full swing for my kids, and that took up plenty of time. I went to Erie the second weekend of September with my best friend Tamara for a marathon... for "our" marathon, the one she was going to pace me to a BQ. It was a difficult weekend, but I wanted to be there, if only for the "girl time". Six of the coolest people in my life went to Michigan with me for my 40th birthday weekend two weeks later, and we had an amazing time together. My life appeared full. But truly, it still felt empty. My workout time has always been in the pre-dawn hours, and I was still missing this time tremendously. Of course my body was missing it, but moreso my heart was. My best friends are all runners, and my time with them is something I treasure more than running itself. I started asking these friends to meet me for early morning coffee dates at Starbucks. I began to accompany Tamara during several of her weekly speedy runs throughout the month of September, biking on her cruiser alongside her. It was almost enough... almost. But I knew that I needed to start actually working out again for my own sanity, so back to the pool I went at the start of October. Swimming is a lonely sport, but it's never hurt me, so swim I did.
Meanwhile, I saw my PCP doctor in August for my annual physical, and asked for the gamut of tests. I thought maybe I was deficient in some necessary mineral or protein, and that was the reason for my frequent injured status. Nothing was too out of the ordinary, except for my TSH (thyroid) level was double what they wanted it to be. This was an odd thing, as I am already medicated for hypothyroidism, but my doctor didn't think too much of it and said we'd just up my medication. I decided I wanted to pursue things further, and requested a referral to an endocrinologist. I saw Dr. Chatterjee in mid-September, and she ran another gamut of tests, including tons of blood work as well as a 24-hour urine collection test to look at my calcium levels. In mid-October, we met again to discuss the results. Only two things came back abnormal: my TSH levels--while they were definitely lower than they were in August, were still higher than she liked (time for another med increase)... and my antibodies showed up positive for Hashimoto's disease. I've had the diagnosis of hypothyroidism for 16 years, but never was tested for Hashimoto's. I've spent the better part of the past 3 weeks learning all that I can about it, and what it potentially means for me as an athlete. That's going to be a totally different blog entry, though, as it's a game changer!
Back to my hip injury... in early September I contacted a well-known hip specialist in my area (Dr. Ellis), but was unable to get in to see him until November 13. My PT recommended a doctor at Ohio State (Dr. Vasileff), so I made an appointment with him, and saw him on October 3. His diagnosis: psoas tendonitis. He gave me a psoas tendon sheath injection that day, and I started PT for this condition a few days later. Sadly, the injection did little to help. I attempted to start interval running (walk/run intervals) a couple of weeks later, (mid-October) and the pain was pretty severe--around a 4 or 5 on a scale of 1 to 10. I knew that whatever was wrong, it was still there. I asked my sports med doctor (Dr. Natalie) to request an MRI with contrast--considered the "gold standard" when it comes to viewing labral tears. If there was a tear, I wanted to know how bad it really was. She got that process started immediately... of course it takes forever for insurance to approve anything at all. So that was a waiting game.
Meanwhile, I decided to see my "voo doo medicine doctor" (sounds way cooler than Airrosti doctor LOL) on 10/26, because if it truly was my psoas, she would be able to help me. She did her Airrosti thing, but told me that she really didn't feel it was my psoas OR the labrum causing my pain. Weirdly enough, a few days after my treatment with her, I felt 100% better in my day-to-day activities. I decided to try an interval run on 10/30, and was elated when the discomfort was very minimal, maybe a 1-2 if that. I did another interval run two days later on the treadmill and felt good... and another two days after that (just this past Sunday, 11/4), and still felt great! The discomfort was so incredibly small that I barely even felt it, especially if I didn't focus on it. I got super excited, and created a training plan that included swimming, aqua jogging, and interval running. I was ready to return to my old self! I saw Dr. Vasileff (hip specialist) at Ohio State last week (10/31), and since the pain-free running was still very new (it had only been a couple of days; I literally had ran pain-free once), I decided not to mention that things were feeling a lot better. I told him that the first injection hadn't worked, so he scheduled me for another injection, this time a hip joint injection, the following Monday morning--3 days ago (11/5). I decided to get it because, well, it certainly wouldn't hurt! (Haha, it is definitely is painful, but you know what I mean!)
Also on Monday morning, shortly after my hip injection was given, Dr. Natalie's office called me The MRI with contrast had finally been approved by my insurance company! I contemplated not even scheduling it, as I figured there really wasn't a point. I was getting better! But I went ahead and called the schedule line, and they actually had an opening the next day. So on Tuesday afternoon I headed out to Delaware for the procedure. It was way more painful than a typical MRI, that's for sure! The injection of contrast wasn't much different than the psoas and hip joint injections I'd already received, but after the procedure was over and they were finished with the MRI (35 minutes of lying motionless, ugh!), I was back to limping worse than ever! Fortunately Dr. Google and Dr. Natalie made me feel better by telling me that this was very typical after an MRI with contrast, and within a couple of hours I was feeling almost back to normal.
Until... I got a message from Dr. Natalie on Tuesday night. The radiologist had read my MRI, and he had called her to share the results. It's never, EVER a good sign when doctors communicate about patients after 6 PM. I was completely and utterly shocked when Dr. Natalie told me that the radiologist had seen a fracture line on the MRI... meaning the stress response had become a true fracture. I was so unprepared to hear this from her. I honestly figured they'd say everything was fine... I thought they'd say that the labral tear was there but healing... worst case scenario, that it was much worse of a tear than they'd thought originally, but not so bad that I needed surgery, just more PT and such. But since I was running again, and relatively pain-free, I didn't expect to hear anything too terrible. And definitely NOT the words "stress fracture".
I immediately canceled my Wednesday morning PT appointment (after all, you don't need PT for a broken hip) and my early plans to interval with my friend Brandi (because I should probably be on crutches, according to Dr. Natalie, so running is definitely not allowed). I had myself a really good, hard cry when I went to bed (thank you, puffy eyes all day Wednesday). And I woke up Wednesday morning thinking that maybe I had dreamed it all, or maybe the radiologist had read someone else's MRI and mistakenly called my doctor. All day at work, I tried to not dwell on the results. But it's not easy to forget something like this.
And Dr. Natalie sent me a picture of the full read from the radiologist late Wednesday night. Seeing it in black and white... "incomplete, nondisplaced transverse stress fracture involving the inferomedial aspect of the right femoral neck"... yep, that's pretty cut and dry. The fracture measures 1.2 cm, which seems HUGE to me. Not sure how it compares to the last one I had... but I can tell you, the pain last time was 100x worse than the pain I have right now. Which is why this fracture diagnosis is truly a mystery to me.
Sooooo... now what? Always the first question I get whenever I tell people about a new injury/diagnosis. And this time, I honestly have no clue. I kept my appointment with Dr. Ellis, the hip guru, and it's finally almost here (next Tuesday, 11/13). I will bring him my MRI films, and hope that he has a different opinion of what he sees. What I personally believe: the fracture happened about a month ago, in early October, when the pain was at its worst. Things are starting to heal, which is why it's not hurting now. I don't believe I need to be on crutches (which is why I am not currently using them), because I am walking with zero pain. Heck, I was RUNNING with zero pain 4 days ago! But if he says I need them, then I will go down that road again. But maybe he will say that the healing has begun, and I just need a few more weeks off.
Meanwhile, I decided last month that if I couldn't train for a running race, I would train for another swim meet. A couple of my triathlon friends and I are doing a meet in Dayton, Ohio on December 1. I have been swimming twice a week, and went back to the Sharks (my old Master's team) for Saturday workouts for this month. I'm not in great swimming shape, but I think that I can definitely pull off a few good 50's for the meet. My doctor said that as long as swimming doesn't hurt (trust me, it doesn't), then I could keep training. So I am trying to focus on that. What I CAN do. I can swim. I can aqua jog. I can cycle. And I'll bide my time... until I can run again.
"Your dream doesn't have an expiration date. Take a deep breath and try again." ~ Kathy Witten
