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.