Surgery Time – Because When It Rains, It Pours

“Surgery?  What in the world are you talking about?  In your last post, you flat out said that you weren’t planning on surgery.”

Well, I’m not.  But there’s more to the story.

Back in January, when I got the MRI for my hip, the report came back with four things.

  1. Labral tear (Yep, expected that.)
  2. Inflammation (No kidding.)
  3. Dermoid cyst on the ovary (Umm, what?)
  4. Unspecified mass on the ovary (Okay, wait a minute…)

So I went to see my gynecologist (who I had just seen a few weeks prior).  She sent me for an ultrasound, which showed that the unspecified mass is likely just partially the cyst and partially an enlarged ovary thanks to the cyst.  She then recommended I go see a gynecologic oncologist, not because she thought it was cancerous (dermoids typically aren’t), but because these kinds of cysts don’t go away and so this one will need to be surgically removed.  Also tested for cancer, but you know, probably not cancer.

So I head off to the gynecologic oncologist two weeks later.  In the time period between the two appointments, I had figured out that a) I needed surgery, b) I wanted to get it done sooner rather than later, and c) that all my races were likely out through the first half of the year.  And I made my peace with that before even seeing the doctor.

I will say, I adored the doctor and her whole staff.  I definitely felt like I was being listened to, and they totally understood my desire to get back to training and fitness.  They drilled me a bit about how I felt about losing my ovary, and I was okay with it.  I only really need one (and the other one looks perfect), and if there’s anything going wrong with the wonky one, let’s get it out.

The doctor was pretty surprised that I don’t feel anything from the cyst.  But as I joked, I’m a triathlete.  Something always hurts.  Also, it’s on the same side of my body as my labral tear, and so some of my abdominal muscles are affected by the compensation – so it’s possible that what I thought was all related to the hip might actually be the cyst as well.

The doctor scheduled me for surgery a little more than 2 weeks out from my appointment.  On one hand, it felt really soon, but on the other hand, I was glad to be getting it done and over with.  Less time to stress about it, more time to recover after the surgery before my mid-summer races.  The surgery is scheduled for next Friday, and thankfully, will be laparoscopic, so my recovery shouldn’t be that bad.

That said, when it comes to getting back to racing, I’m now dealing with my hip and abdominal surgery.  I’ll be up and walking right away, and can get back to cycling as I feel like it.  No swimming for 4 weeks, unfortunately.  And I checked my various PT exercises with my doctor and she cleared me to do certain ones right away because they don’t involve my abs.  (Also I can still do planks because I can’t cheat them – so even surgery won’t get me out of planks.)

I’m definitely not going to push anything.  I’m going to recover and I”m going to recover right.  I’m scheduled to take a full two weeks off of work, but I expect to be teleworking during some of that purely out of boredom rather than anything else.  I’m going to do what I can, but not worry too much about it – just heal well.  I’m planning to get back to training with my coach after 4 weeks, provided everything feels good, and assuming I get clearance from my doctor.

In terms of racing, I’m pulling out of everything through May.  That includes BDR New Orleans and, yes, 70.3 Chattanooga.  I have to admit, I’m not too bummed about missing that, because I think I already knew it was in question with my hip injury.  That said, I will still be going to the race to cheer on friends and teammates.  I think I would be too sad sitting at home and tracking.  I won’t be racing, but I can still share in the day.

It turns out this hip injury was a good thing.  Who knows when this cyst would have been found without it?  It is in a spot where the surgeon thinks torsion is unlikely, but since it’s not causing pain, it could have just continued to grow until it was too big to remove laparoscopically.  And that would be a much bigger surgery.  Plus now I can deal with all of this at once.  I can continue to rest and rehab my hip and be ready for racing again.

My goal is to be back racing at Rev3 Williamsburg in early July.  I’m registered for the Olympic Triathlon, and my surgeon thinks that’s absolutely doable (she thinks triathletes are crazy, of course, and she’s not wrong).  And if my hip isn’t ready for a 10k run?  Rev3 has an aquabike option, and I can switch at any point.  I will be out there in some fashion and I can’t wait!  This is just another rough patch I have to get through first.

 

Labral Tear Update

So I’m still dealing with this labral tear, and it’s definitely slow going.  Though let’s be honest, when is the last time that healing anything wasn’t slow going?  (Not that the tear itself can be healed, but there are things I can do to reduce pain and prevent issues.)

Let’s look back at where I’ve been –

Mid-November – I go on a six mile taper run and have a bunch of weird pain in my left quad and end up walking most of it.  I shrug it off.

Late November – Space Coast!  I run with Kim and we have a blast until I tweak my right soleus (likely due to a tight piriformis combined with some wicked camber on the course) at mile 12.

Mid-December – I do a 3 mile run, no real issues til the end when my soleus starts to hurt.  Guess that’s not quite healed.

Late December – For the rest of the month, when I try to run, my quad almost immediately starts to hurt.  It is not awesome.  It is super inflamed and painful.  The pain is along the top of my quad and down the outer side. So I stop running.  Only biking and swimming

Early January – Cheer at WDW Marathon.  No running, but tons and tons of walking, and zero issues.

January 16 – Appointment with regenerative orthopedist.  He talks very fast, and while very nice, does not leave me feeling great about the appointment.  He orders an x-ray and an MRI, says it’s probably a labral tear or maybe a stress fracture, but that I can still run (not the best plan, if it’s a stress fracture).  Throws a whole lot of information at me about regenerative therapies and injections, and tells me to come back in a month.

January 17 – I decide to try to get in with another orthopedist, one who does more traditional therapies.  Get an appointment for the following week.

January 19 – X-Ray and MRI.  MRIs remain un-fun for someone who is claustrophobic, but I survive.

January 23 – Appointment with the new orthopedist.  I immediately like him better.  He looks at my scans and the reports, and there is very clearly a labral tear (and no stress fracture) in my left hip.  He gives me a ten day course of prednisone, tells me to wear supportive shoes, prescribes PT, and tells me to come back in three weeks, and that I can try running in two weeks.  So off I go with my happy new plan.

February 6 – I run one mile.  It hurts.

February 8 – I attempt to run another mile, realize that it hurts right away and that this is stupid.  My PT was surprised that the doctor wanted me to try running so soon, and she was right.  I wasn’t ready.

February 13 – I return to the orthopedist for my followup.  He seems surprised I’m not 100% better.  He asks if I want to talk to a surgeon.  I tell him that I’m not ready for that option.  He recommends I consider a cortisone injection, and I take the information.  He basically says that none of these are requirements and I’m not causing harm by continuing to just do PT and waiting to see how things go.

Surgery is definitely not in my plans.  The recovery time is a full 6 months, and it’s not a guaranteed fix.  Additionally, were I to consider surgery, it wouldn’t be until the fall.  We’re doing a Northern European cruise in August, and it’s been planned for years.  I refuse to be hobbling around and dealing with recovery while sight-seeing.

I’m reluctant to try the cortisone right now as well.  I’ve done quite a bit of research and it can have a catabolic effect.  Now, if I were in pain during my normal day-to-day activities, I would absolutely be considering it.  But it also isn’t a permanent fix, and if the biggest issue is that I can’t run, I’m not sure it’s worth it right now.

For now, my plan is to continue with PT.  While my exercises are getting easier, they are far from easy.  I have a lot of strengthening work to do.  I’m certainly hoping to be able to get back to running, but I’m definitely taking the conservative approach right now.  It’s incredibly frustrating, but I’d rather be cautious than jump into bigger treatments that don’t work.

If, after some time has passed, I’m still finding that things aren’t improving (I think they are, it’s just hard to tell), I may consider going back to the regenerative ortho.  Patience is going to be the name of the game here.  Slow and steady.

There is no magical cure

Prawny / Pixabay

So Tuesday was my glorious return to running.

It was not glorious.  At all.

I ran one whole mile.  Well, ran/walked.

It was very slow.

And it hurt.

I think I got a little cocky after my required rest.  Also the prednisone I was on.  It significantly reduced all the inflammation in my leg muscles and suddenly nothing hurt.  It was awesome.

Well, I tapered off of that a few days back, so now some of the inflammation is rearing its ugly head.  And obviously, two weeks of physical therapy isn’t enough to completely rebuild the muscles needed to support the tear in my hip.

The good thing that the pain wasn’t at the point of the tear itself.  It was in the muscles opposite it.  When I run, my leg also seems to naturally want to move at an angle instead of straight.  I can keep it straight, but have to consciously work to keep it there.  I talked to my PT about it, and she agreed that’s an easy fix.  And by easy, I mean a lot of quality PT work, both in the office and at home.  But nothing complicated or particularly hard to do.

This weekend is the first race that I’ve had to officially DNS due to this injury.  I’m definitely disappointed to not be running Donna this year, as it’s always a great race.  This may not be the only race I DNS this year, and that’s definitely a bummer, but I’m much more committed to racing healthy and pain free than I am to actually completing a race.  Right now, biking and swimming are painless (well, free from the bad pain anyway), so worst case, I can do some aquabike races this year.  However, it’s only February, so we’ll see what the next few weeks hold.  Not committing to anything just yet.

 

The Wheels on the Bike Go Round and Round

Guys.  GUYS.  I get to try out running THIS WEEK.  Like, tomorrow!  I’m 100% excited and 100% terrified and 100% convinced it’s gonna be awful.

running is impossible

But it’s also going to be 100% exciting because I can finally, finally try running again.

Because while I love biking, it’s getting to be a bit much.  Don’t get me wrong, my bike and I are still BFFs, but after three straight days on the trainer, I’m a little bit saddle sore.  I know, I know, it’s only three days and lots of people do way more, but I got into triathlon because I like doing multiple things.  I get bored easily!  Also my treadmill is getting dusty, and I’m pretty sure this is the longest I’ve gone without running on it since I bought it over 6 years ago.

That said, I’ve really gotten into riding on Zwift.  I love the added challenge of the hills and valleys, and I absolutely love the scenery.  Seriously, how gorgeous is this?

Don’t judge my overall speed – it was a hilly route.

I have to admit, I also love the gamification of the workouts.  I can challenge myself up hills and through sprints.  I can earn virtual jerseys and other gear to “wear” during the ride.  I can cheer on my friends as they ride (and spy on them if I want).  I can see how many pieces of pizza I burned during my workout (spoiler alert: it’s never as much as you think).

I have never minded indoor training, as it’s often an excuse to catch up on tv shows I’ve missed, but after using Zwift for a few months, I see just how much I was holding back on my trainer rides.  It’s easy to push myself on the treadmill – I push the buttons and I have to run faster or I fall.  But the bike is entirely self powered, so if I take it easy, there’s nothing there to force me to speed up.  Having my Zwift screen in front of me is that reminder, especially when I’m cruising up a hill at a whopping 2 miles per hour.  Seriously, if I were actually riding, I would have fallen over.  (Of course, I tend to avoid hills with a 10% grade.)

So thank you, Zwift, for getting me through these past few months, but I think maybe we’ll be seeing each other just a bit less, now that the treadmill and I are allowed to get reacquainted.

January Mileage Update

depuys / Pixabay

I really liked tracking my mileage last year, so this year, I set some concrete mileage goals and headed out to meet them.

You know what they say about the best laid plans.

But injuries happen, and goals are meant to be adjusted as circumstances change.  So rather than being disappointed about my current mileage numbers, I find them pretty amusing.  I’m not going to worry about changing the goals, I’ll just see where I end up.

January Mileage:
Swim: 6.2 miles
Bike: 170 miles
Run: 3 miles

I’m ahead of the game on the swim for sure, thanks to the 100×100 swim (of which I did 53) setup by one of my amazing Coeur teammates.  My goal for this year’s swim was to swim smart and not aggravate my hip, but if possible, I wanted to beat last year’s swim.  Last year, I did 5000y, so this year, I did 5300y.  This year, I also didn’t touch any pool toys while swimming.  No pull buoy, fins, or paddles.  That was mainly out of concern for my hip, but it certainly made the swim more of a challenge.  That said, it’s a huge confidence builder for the beginning of the season, whatever that season may look like.

Bike numbers are a bit low, but it’s been a lot of indoor challenges.  I’m using Zwift now, so it’s not really comparable to my indoor mileage from last year, but Zwift makes it way more fun, so I’ll take the slightly lower mileage.  I’m definitely itching to get outside, but not when it’s this cold.  There is no good way to bike while wearing a snowsuit, and I salute all you bike commuters.

So on to the next month.  Here’s hoping February has some goodness saved up for me!