Back to Reality

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After a glorious two weeks at home, it’s back to reality.  Yes, I’m back at work this week.  And to be honest, it’s not so bad.  In terms of recovery, I don’t think I actually needed the full two weeks off, but it was certainly better safe than sorry.  The added rest was certainly nice, and I’m sure the lower stress level helped too.

Week one was pretty quiet.  I spent a lot of time just hanging out and watching tv.  I made a few quick outings, nothing too strenuous, and a week after surgery, I was able to walk on the treadmill, though it was slow going.  By Wednesday of the next week I was feeling pretty great.  Still being careful, but I could get on my bike without pain and spent some time doing small projects around the house (while still getting in quality couch time with the cats).

Work hasn’t been bad at all.  Monday I did a full day, went for a 2 mile walk at lunch, and still had plenty of energy for a bike ride that evening.  I’d say I’m well on my way to recovery.

In terms of training, I’m taking that much more slowly.  I’m not allowed to swim for four weeks, so basically, I won’t be making a return to the pool til April.  I haven’t been running because of my hip, but I’m working with my physical therapist (going back this week), and we’re going to make a plan to get me back to running.  And I’m easing into biking, not pushing too hard.

Obviously, I haven’t been working with my coach this month and I think I’m going to take April off from formal training as well, and just work with what feels good.  Plan a workout, but just do it by feel.  I’ll still try to get in 2 workouts from each sport, but not overtax myself.  After all, I don’t have any major race goals this year except to cross some finish lines.  I’m not racing til July.  Plenty of time to get ready.

Of course, as I watch the snow come down outside my window, it’s a bit strange to be thinking about triathlon!  Happy spring?

Mental Health – It’s not just in your head

Over the past week, I’ve seen a number of things floating around pushing the importance of exercise for your mental health. One article (which I will not link) went so far as to imply that in many cases of depression, exercise works just as well as medication. And we’ve all heard the saying “Running is cheaper than therapy.” And that’s true. Exercise is great for helping you feel better.

Until it doesn’t.

Recently, Outside magazine had a phenomenal article about anxiety and mental health. This is one of the best descriptions of anxiety that I have read in a long time. For those of you who have experienced it, you will recall the feelings immediately. For those of you who haven’t, I recommend checking out the whole article.

When the anxiety is at its worst, I’m not present for anything. It’s as if I’m going through life with my hands in front of my face. It’s an overwhelming and devastating feeling that is very different from what I used to think anxiety was (feeling exceedingly nervous before a public speaking gig or butterflies on the start line of a marathon, for example). It can feel like I’m two different people. During “normal” periods, my non-anxious self knows how irrational my anxious self is being, but my anxious self doesn’t abide by reason.

Read that last sentence again. It’s so incredibly true. People with anxiety can see that their anxiety is often irrational, but when trapped in that anxiety, you can’t see the way out.

I have suffered from anxiety for years. Probably the majority of my life, or at least since I was old enough to be anxious about something. At its worst, I had a doctor look at me, tap his pen against the running shoes I was wearing, and tell me that I needed to be using those shoes for their purpose and not just wearing them to walk around. At the time, I was in the middle of training for a half marathon.  Clearly, exercise wasn’t going to work, and honestly, it was really insulting to hear that from a medical professional.

Now that’s not to say that exercise doesn’t help.  I do feel better when I’m getting the extra endorphins from exercise.  I think I’m a happier person when I’m able to workout.  But I’m not sure it has a huge effect on my anxiety levels.  My anxiety is a product of screwy brain chemistry, and what works is medication.  And I’m not ashamed of that.

Current society has such a stigma against mental health medications.  We don’t shame people for needing glasses (okay, so some kids will tease other kids with glasses, but that’s a different story).  And what are glasses but something to correct vision that doesn’t work quite right thanks to changes completely out of our control.  And sure, there might be some things you can do to help your vision, like taking a break from the computer every hour, but these things are very minor, and for the majority of people who need glasses, won’t help much.

Medication for depression or anxiety is the same.  Sure, there are some minor things you can do to help your situation, but often times, the issue just can’t be fixed without medication.  Can you function without it?  Sure, some people can.  But for others, it is excessively challenging, to the point of being unable to get through daily functions.

I’m not saying that everyone on medication for mental health needs to shout it from the rooftops.  We all have a right to privacy, and no one has to share anything about their health with the general public.  But we should remember that there are many people out there who take medications for their mental health, and there are many people who are too ashamed to talk to their health care providers about medications because of the stigma.  No one should ever be ashamed of their health status.

So yes.  Exercise can help improve your mental health.  But it’s not the only solution and for many people, it’s not the best solution.  So if you need something more than exercise, you shouldn’t be ashamed or feel like you’ve failed in any way.  It’s ok to not be ok.

Update: Ovarian Cyst Removal & Recovery

Alexas_Fotos / Pixabay

So I’m now five days past surgery and feeling pretty good. I’m moving pretty well, but not doing any activity other than walking. If the weather were nicer, I’d probably go on a walk around the neighborhood, but instead I’m just doing laps around the house.

One of the worst parts of surgery for me was the unknown. I wasn’t sure what was going to happen and I was definitely nervous. I looked online to see if other people had talked about their surgeries, and most of what I found was stuff about hysterectomies, which I suppose is similar, but a much larger surgery. So I thought I’d put my experience out there.

My scheduled surgery was a laparoscopic procedure to remove a large dermoid cyst on my ovary, plus the ovary and Fallopian tube. For funsies, my doctor had me do a bowel prep, meaning I needed to be totally empty prior to the surgery. That way if something happened and the bowel got nicked, it wasn’t as big of an issue. And the bowel prep was totally not bad at all. I think staying hydrated definitely helped. I never had bad cramping or any issues.

Surgery day dawned with an insane windstorm. Tropical storm strength winds. So that made for a slightly sleepless night the night before. Not that I planned to sleep all that well anyway. I made my way to the hospital with my mom and my sister, who flew in for my surgery. It was definitely nice to have them there.

Not long after we got there, we headed back to the pre-surgical area. I got into my super cute gown and they hooked me up to a saline IV. And then the waiting began. I think I was in a bit of a daze from exhaustion and hunger. I expected to be freaking out and I didn’t feel as stressed as I thought I would be. As most things go with hospitals, there was a lot of waiting. I also saw a lot of people. There was a pre-op nurse, and the surgeon came by, as well as the anesthesiologist and the nurse anesthetist. Finally, after a couple of hours, it was time to head back to surgery. I got to ride on the gurney into the operating room. I didn’t have my glasses on at this point, so it was hard to see much other than the giant lights on the ceiling. They had me shift over onto the operating table, which was cushioned, something I didn’t expect. Then I remember them saying they were going to hang the good drugs, and that’s all I remember.

I came out of anesthesia in a chair, pretty much in a daze. I had an oxygen cannula in my nose, and my head was definitely spinning. I was never nauseous (thanks to the drugs from the anesthesiologist), but I couldn’t get my eyes to focus. They gave me some additional pain meds, and after the debacle with my “high” heart rate (my HR is higher as part of my heart rhythm, I hadn’t had my normal anti-anxiety drug, and they kept saying surgery was “more” than expected – which I worried meant cancer, but really meant the main incision was just a bit bigger), I was released, given some ginger ale and graham crackers, and my family was allowed to come in. I had to very carefully get up, but I was free.

Walking was a bit rough due to pulling in my lower abs, but stairs were never an issue. Stairs didn’t hurt at all, which was totally unexpected. I credit this to my general fitness level and all the PT I’ve been doing to strengthen my hips and legs. After the first day, I stopped taking the “good” drugs and have just been taking ibuprofen. The pain is like the feeling the day after you do a crazy ab workout and regret everything. It hurts, but it’s just the muscles, and once I’m moving, it’s not so bad. At first rolling over to get out of bed was rough, but that’s much better by now.

I’m really taking it easy and doing a lot of lounging. Catching up on tv and reading. Petting the cats. Because even though I’m feeling pretty good, my body is still healing. My abdomen is definitely still bloated, and I’m a little afraid I will be wearing yoga pants when I finally do go back to work. I took a full two weeks off, but will likely do some telework next week to stave off boredom.

I’ve got a Follow-up with my surgeon in a few weeks, but I expect to be fully cleared to get back to training. It’s all about easing back in (and also continuing to rehab my hip), but this surgery seems to just be a bump in the road.

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.