Sunday, March 30, 2014

An Update & Tips for Surviving Injury -- Surprise! Not Running Won't Kill Ya!

Greetings from the healing front! Since I last wrote, it's been a good almost three weeks of vacationing, healing and getting back into the swing of a painkiller and cast-free life following the initial first couple weeks of post-surgery haze. A quick recap...

Shortly after my last post, I drove 20 hours with my husband to the Florida panhandle for his spring break (teacher). This turned out to not only be a great R&R opportunity, but also a remarkable way to kick-start the next phase of my healing, since I had just had my cast removed. The highlights: Good eats and lots of sun. Our days were simple, as they usually are...a morning run (for him) and a trip to a cute little beachside fitness center (for me) where I purchased a three-day pass. This hadn't been anything I had planned for or anticipated...my husband is training for Boston and logging big miles and I figured I'd have a couple hours each morning to lounge around and do whatever. But when I saw the opportunity to work out in a nice little gym, I figured I'd kick-start my cross training in earnest when Derek was out running. It worked out great...I got to bike while catching up on trashy reality t.v. 

We then spent our afternoons at the beach, where I soaked up some bone-healing vitamin D. I was the only person on the beach with crutches and wearing a boot (from what I can tell), and I have a sweet tan line to show for it, but it was super relaxing and enjoyable. I slept and read Unbroken (read it!). Wonderful. 

That brings me to today...I've got a week of normal, in-office working under my belt (I'd mostly worked from home for the couple weeks following surgery) and I'm back in a pretty decent routine. Most notably, I'm no longer using the crutches much around the house, and when I have the boot off for showering or bed, I've actually been able to walk without it and not feel any pain -- though I've been keeping the weight on the outside of my foot and not pushing much off the ball, since I don't have the okay to do that yet and I am ALL ABOUT doing this recovery right. As for cross training, I've got that deal through my insurance where I have to go to the gym a certain number of times a month to get a discount, so it's kept me going. I've been riding the bike -- upright and recumbent -- and working the mind-numbing arm bike every now and then. The routine of going to the gym got me thinking about what gets me there and what keeps me motivated and sane while dealing with this long recovery. And with that, here's my running list of tips and tricks for dealing with injury and cross training...I reserve the right to edit and add to these as I think of them...

1. Cherish the gift of time. Good news! Time heals...and time doesn't stop! Take comfort in knowing you'll eventually heal if you give it time. Now, in my case, I needed surgery because time wouldn't heal...nothing would without surgical intervention. But! Now that I've had surgery, time will heal! And with that...don't forget to take your time! I've had my share of races ruined by injuries that kept me from even starting. Several marathons, in fact. It sucks -- the time and financial investment is huge. But there really will always be another race, if you do the healing thing right and give it TIME. That actually leads to my next point...

2. When it comes to running, change your view from short- to long-term. I completely went against this in 2007 with my last major injury -- a ruptured posterior tibial tendon. I was coming off a great fall in 2006 and running the best times of my life and was training to break three hours in the marathon. Then, I developed bad tendonitis. I never fully committed to taking time off and was like a runaway train, on the cusp of meeting my goal and in a panic to keep training and racing to achieve it, running as if it was my last chance ever and just taking a half-assed approach to dealing with my nagging tendonitis that eventually came back to bite me way worse than I would have ever imagined. The ironic thing is, I truly never have run as well as I did then, but guess what? Much of it is due to injury derailment--including that major injury, which knocked me out completely for six months (zero running), followed by many more months of slowly coming back. Other things have popped up that have changed how I've trained and what I've achieved, but I can most definitely say that my short-term view on running and goals was a detriment to my health and running at the time. Fast forward to this most recent injury -- my lisfranc injury that led to surgery. When it became an issue, I immediately thought, what do I want out of running for the remainder of my life? I could deal with missing races and workouts and much of a racing season if it set me up to be able to run well into the latter years of my life. This is a lifelong thing for me, and so I had to commit to it as such. Don't shoot yourself in the foot (haha) to achieve some short-term goal or because you're afraid of taking a step back and losing fitness. Commit to what will keep you strong in the long term.

3. Running injured sucks. Be honest with yourself: if you're perpetually in pain and dealing with a chronic issue, how long are you willing to deal with it? When will it stop? The short-term disappointment of not being able to run is COMPLETELY worth it for healthy running later on. Trust me. And really, are you running to your full potential with that chronic pain? Probably not.

4. You don't have to lose ALL fitness and semblance of athleticism when injured. Yes, not running will make you lose running fitness. There's no getting around that. Even if you cross train perfectly and remain fit, nothing will totally be the perfect substitute, so just accept it. But if you had it once, you'll get it back eventually if you're willing to work for it again like you once were (and I bet you're willing!). We runners can be narrowly-focused on our running and all its various forms and poo-poo cross training (GUILTY AS CHARGED!). However, at the very least, it can be a nice outlet for energy in place of running, and you can even get a decent workout! My dear friend Nicole once gave me a really simple tip I've carried with me through many injuries as I try and navigate the maze of equipment at the gym: keep the resistance low and just focus on getting your heart rate high. This advice was actually passed along to her from a 2004 T&F Olympian who ran some great races off of running and cross training, so I paid attention. That goes for the elliptical, the stationary bike, the arm bike...you name it. Don't "mash gears," as the cyclists say, or throw yourself into the elliptical trying to move what feels like sumo wrestler resistance. Keep it low and aim for high intensity. I've been following this on the bike, the only thing I can really do, and have been pleasantly surprised by the sense of accomplishment I'm able to achieve given the effort required for some of the bike sessions I've done. Simply focusing on moving my legs with a high RPM has enabled me to get my heart rate in the 150-160 range. Of course it's not running, but if you're looking for a good workout, just focus on heart rate and I promise it will help fill the void at least a little!

Also, don't underestimate other things you'll have to do because of injury...for me, crutching around has actually proven to be a decent workout! A trip to the grocery store with my husband, for example, is like a trip to the weight room. 

5. Connect with others for support. My Oiselle teammates have been amazing sources of strength and support as I recover, as have my running friends who have checked in and simply helped keep me connected to that world I'm currently not "running" in. And, I'll be completely honest--being around others who don't run and aren't focused on anything related to running is also therapeutic and a good way to remind yourself that there is so much more to life, and this, too shall pass. 

6. Keep perspective. I will never short change the power of running and its ability to change lives, empower people, and transform relationships and how we see ourselves. BUT, life without it for a period of time in the name of healing is okay in the long run. It's temporary, and it's also a good time to take stock of the balance in your life. In the grand scheme of life, this will just be a small blip on the radar. In a month, six months or year, you probably will barely remember this time.

What am I missing? Stay healthy, friends!






Tuesday, March 11, 2014

Reality Bites (Ouch!)

First off, I hate that I have no running updates for this running blog. As I mentioned before, I'm hoping documenting my recovery from joint fusion surgery in my foot -- which I did to hopefully return to pain-free living and activities, including running -- will help keep me motivated and provide a good way to track my progress and hopefully not make too many mistakes. I've also never been good about cross training and know I better get used to it if I want to maintain any fitness during this layoff, so a blog should be an interesting way to see how things unfold. Anyway...

My big return to working from the office today instead of from home wasn't as magical as I thought, simply because it HURT. As I mentioned in the update at the bottom of my last post, my cast came off this morning and I went straight to work. Like a fool, I had this idea that the cast was the closing of a significant chapter and things would get easier. Unfortunately, they haven't. And me not being smart about this meant I brought a giant purse to work. Pro tip: Don't carry a big purse while on crutches. If it doesn't get tangled with your body and the crutch and cause you to feel like you're about to trip any moment, it will fall down to your elbow...and cause you to feel like you're about to trip any moment. Let's just say that I ditched the purse in my office drawer when I left at the end of the day and just put my wallet and phone in my laptop backpack.

I guess the bigger issue with today was I went with my natural tendency to PUSH PUSH PUSH and jumped back into a normal day. That included not having my foot elevated for the majority of the day (I finally broke down due to the pain at the end of the day and put my feet up on my desk while I read through some materials I had to review). I've had my foot elevated for the majority of the day for the past 12 days, so this was a bonehead move. I also tried doing a little walking on my heel without my crutches (going to the printer, going to the water cooler), which was a little too ambitious. The result: I left work a little early because I was in the most pain I've been in since I had surgery. The days immediately following surgery, when I had a giant foot with big swollen sausage toes, weren't even this bad! I had this idea this morning when I left for work that I'd even stop by the gym on my way home to do a little stationary biking. Nope. I came straight home, put my foot up and removed the air cast and my sock. My foot is more swollen than it was when I came out of my hard cast this morning, and I've got more bruising than I remember (including purple toes).

I clearly overdid it this morning and today was a huge reality check. This isn't going to be quick and easy. Of course it's not. I intellectually know that but my natural inclinations go against it and I don't make the best decisions when it comes to these things. I can't wait to return to running but I can't jeopardize my recovery by rushing it like I did. I'm going to have to re-evaluate my approach and take it even easier than I thought...

Any surgery recovery tips or experiences out there to make me feel better? Any recommendations for getting good cross training in when you're severely limited in what you can do?

Monday, March 10, 2014

Surgery Recovery Week 2: Coming Out Of The Haze

I'm finishing up week two of surgery recovery (Wednesday will be two weeks since the day) and am happy to say I've left the house twice during that time--once on Saturday and then this evening to go to the gym for the first time since the surgery (more on that later). Yes, I stayed inside for 10 straight days. Now, before you go thinking this is disgusting, let me describe the scenario: I was on a steady diet of percocet every 4-6 hours for several days and oxycontin every 12 hours. I'd say it wasn't until Sunday after my surgery I could eat at the table and stay awake more than an hour at a time. Drugs and surgery recovery are no joke!

Monday a week ago I "went back" to work, which meant I crutched over to the dining room table around 7:30 or 8:00 a.m., logged on to the network, IM and email, turned on my phone, propped up my big ol' casted foot and leg on a chair next to me and got to work until 5 or 6 p.m. It was tough in the first few days to keep up with my expected levels of productivity while fighting through the tremendous fog--I'm not going to lie! One day I was especially crabby and tired of the situation and ventured out to the back stoop of the house for the first time in a week. I sat there for five minutes, breathed in the fresh air and felt rejuvenated, but also like I had just slept through an entire week while the world moved on.

By Friday, as the pain pills were dwindling and the hours between dosages got longer, I not-so-coincidentally felt like I had my clarity back and actually could get into a work groove. And, I started to have that feeling of "AHHH, I just want to MOVE and get outside and be active." I consider that a good thing and totally normal that I made it that long before feeling that way. People had asked earlier how I was doing and how long before I could cross train or whatever, and honestly, the first several days post surgery I was so nauseous and drowsy, changing my clothes was enough "cardio." My surgeon had said two weeks after surgery, when I get my cast removed (which is tomorrow), I could start riding a stationary bike. Hooray.

But really, I've been looking at this as a two week break. As runners, we can be very disciplined and regimented--guilty as charged. So much so, in fact, that we often  don't consider a run a true workout or effort without hitting a certain number of miles. A long run might not be anything less than 90 minutes, for example, or a run might not be worthy of a mention unless it's at least five miles. At times in my life, I've been there. And I do think you have to be disciplined and regimented when going after specific goals. But this time has been good for me to just let go. Not let go in the sense that I completely fall off the wagon nutrition-wise, but honestly, a couple weeks of rest is okay -- especially after surgery. And it's been pretty nice!

This evening, though, I made my triumphant (okay, not quite) return to the gym. Because I'm still on crutches and going to the gym in the afternoon means having to park in the far corners of the lot and hike in, my husband was kind enough to take me there and drop me off at the door (nice!). He then went for a run and said he'd be back in about an hour. Knowing this, I had to figure out what in the world to do with myself. I can't exactly bike with this foot-to-top-of-my-calf cast on, nor can I do anything standing, obviously. My option: the devil exercise machine, the arm bike. Since it took some time for me to crutch in, go to the locker room and take the elevator up to the workout floor, I figured Derek would be back now in less than hour. So I sat and just pedaled with my arms. And pedaled. And holy hell, is that thing hard. Three minutes in I was searching for an exit and in my panic formed a plan: alternate directions every five minutes and hand positions after every set (forward and back). And, alternate hard and steady efforts every minute. I'll tell you this: It was boring as all get out.

One hour later (actually 15 seconds before I hit the hour mark), Derek strolled up and I was done! It was very convenient timing and I ended up on that thing much longer than I would have expected. I realized the downfall of this when I stood up to crutch away -- my arms! -- but all in all, it felt good to move and sweat a little. (Okay, that's not the first time I've sweat -- there have been mornings when I've felt the beads of sweat forming on the back of my neck as I crutched around trying to get ready for the day after Derek has left for the work...but whatever.)

Tomorrow, I have my first post-op check up and I am OH SO EXCITED at the prospect of hopefully getting my cast off. I believe I get to have my stitches removed, and in order to do that the cast has to come off, so let's hope it stays off! I've had an itch I've wanted to scratch for almost two weeks now...

UPDATE AS OF 3-10-14: Had my appointment and saw my foot for the first time since surgery. Not going to lie -- my vanity got the best of me and I was a little grossed out by not only my ugly, scarred up foot, but also HOW MUCH MY CALF SHRUNK. Ugh. Got the cast and stitches removed and graduated to a removable air cast, so...progress! But, I still have to use crutches because I'm only supposed to put weight on my heel (trust me, my foot has already told me when I'm not and it isn't happy when that happens). This made for a somewhat challenging walk into work...I had a backpack and a too-big purse and by the time I got to my desk, my foot was throbbing and I had broken a sweat. But, I know it will get better. I go back in four weeks when they'll take x-rays and I can hopefully graduate from the aircast and start bearing more weight. The PA said the surgery involved a bone graft and fusion so those bones still have a lot of healing to do.

Saturday, March 1, 2014

Commence Recovery!

I'm going to make this brief because the cocktail pain pills I'm currently on have turned me into a spacey, no-attention-span and slightly nauseous blob, and I don't trust myself to write too much at the moment. But I wanted to document the "highlight" of the past week: Foot surgery! I checked in on Wednesday morning at 6:00 a.m., went under at 8:30 a.m. (complete with a "take a couple deep breaths"....and that's all I remember) and was home by 11 a.m.! Yep, it was that quick, and from all accounts, it went well. I now have a plate and screws between my first and second metatarsals, back at the midfoot joint where they intersect, which will hopefully heal into a rock-solid, stabilized joint that will be able to withstand all the activity I want in the future.

At the moment, I'm in a cast and crutching around. I haven't left the house since I got home, but that's all right -- I can only stand to have my foot in a non-elevated position for about 10 minutes max before it starts throbbing and the cast begins to feel too tight due to swelling. This will eventually subside, and for now I'm just trying to live in the moment and not worry about too much besides letting it HEAL. It dawned on me this morning that I was injured before, and I'm not "injured" anymore...I'm fixed, and now my body is finally healing!

I have my first post-opp appointment on March 11, when I'll get my cast off and my stitches removed. My surgeon told me on Wednesday I can then start biking (hello, spin classes!), and he thinks I'll be ready to start running 12 weeks post-surgery. So, basically like the recovery time required for a stress fracture. I can do this!

I'm going to try my hardest to document my recovery so I can maybe learn a thing or two from it. It probably won't be very exciting--especially during these first few days/weeks (seriously, the pain pills I'm on are the most "interesting" part). But it will be nice to look back on it in six months or a year when I'm hopefully super healthy and this is all a distant memory.