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Wednesday, December 31, 2014

Picking up the pieces and moving forward-a little end of the year update!

  So, the another year is in the books.  I can't say it was everything I dreamed it would be and more, but in sport and in life, we learn from both the ups and the downs; life isn't a linear progression all of the time, after all.  And race results (or lack thereof) can't undo all of the benefits that happen from the training and learning that goes on before and afterwards.  When it comes down to it, I basically had a bad month (mid-February to mid-March), and then a couple of unlucky days in June and November-hardly the end of the world there  For me, 2015 will be about leaving those downs behind and building on the ups.  I can't do that immediately-my injuries (and whatever plague hit me yesterday-thanks for that, 2014, but better to get it out of the way now) are going to follow me past midnight tonight, after all-but eventually, those demons will get left behind.  Until then, just wanted to provide a bit of a more "formal" update on everything that's gone on in the past month!

  The first week after the crash, I was expecting to hurt a lot, and I did.  The SI/sacral area pain was really the worst of it.  I couldn't really walk all that well, but I was still able to blame it all on maybe some sprained ligaments, maybe a thrown out SI, whiplash, and lots of muscle guarding and spasm.  The road rash distracted me somewhat, and I was simultaneously grossed out by it, but sort of interested in it.  I still don't fully grasp the miracle known as Tegaderm, the magic scab healing film, but thankfully that turned the surface wounds into the least of my worries.  I took tramadol, and put up the Christmas decorations because darn it, they made me happy (and because I've apparently inherited my father's genetic code when it comes to injury).  When my PA sister saw me "walking" by the end of the week, she told me to get an MRI.  I told her that I was fine, that I had sprained the joint, that I didn't want to blow the HSA money on it.  I was going to rest anyways, after all, it was off season.  I'd seem patients after car accidents with whiplash injuries, and they were in a lot of pain without any specific structures being injured.  A few days later, I started to get a little more concerned.  I still couldn't weight bear without any pain.  I was getting more motion in the hip, but my gait still looked pretty bad.  I had told my boss via text that I was walking better-but he gave me one incredulous look as I limped into the office that day.  I emailed Jesse, he told me it was still normal after a bike crash to be pretty rough.  Well, ok.  I was able to live in a little bit more denial-I can bend at the waist more than 10 degrees now!  You're only walking funny because your glute med got shut off for a bit!  A couple of nights later, I looked in the mirror, and I tried to force myself to walk normally.  You're fine, it's just a learned gait pattern now, you have to make yourself be normal.  For 15min or so, I walked around the house, trying to avoid limping.  I spent that night laying awake in abject pain.  The next night, I realized that I didn't even want to go to bed, because I wouldn't be able to get comfortable, anyways.  I finally texted my sister-I think I need that MRI.  

  That weekend (two weeks later), we went off to Boston for the annual QT2 party.  I was starting to actually feel a little better, so I went to the mall for about an hour and a half the day before leaving to get some Christmas shopping done.  I wanted to be normal and active and up and about again, so I took more tramadol and forced it.  I employed all of my athlete mental strength, mind over matter techniques, still feeling like a bit of a wimp for being so gimpy still.  The next day, we walked around Quincy Market for a couple of hours, then stood longer at the party.  In that time, too, my ribs had started to really hurt too-any pressure, pushing, lifting, laughing, sneezing, etc were not so fun (it did at least get me out of driving, as checking over my shoulder or even operating the blinker sucked a bit).  That night ended up being the first time that I became truly scared about something more sinister.  Walking back to our hotel room after the party, my hip entirely stopped working.  It was simultaneously frightening and fascinating-what is going on?  For the first time since the first night, I literally just could not walk; everything in the right (non-impact) side of my pelvis screamed bloody murder the second that I tried to put any weight through it.  At the end of it, Dave ended up carrying me, dress and all, from the elevator to our hotel room.  The next two nights, I would lay awake with a new pain-a deep, sharp, throbbing groin pain, that I could feel intensify with every beat of my heart.  Thanks to my PT knowledge, I knew that throbbing+night pain=bone.  And I also knew that groin pain=hip referral.  And I knew that anterior hip fractures could potentially=very bad news.  By that point, the MRI was scheduled for Tuesday.  I didn't really say much about it, because A. we were still waiting for preauthorization, and B. I somehow still had it in my head that I was full of it, that nothing was wrong with me, that I was going to look pretty darn stupid when nothing showed up, but I was just complaining a bunch and faking a limp and being a wimp.  Still, the night before the MRI, I had told Jesse, this all seems very wrong to me....

  In the MRI tube, I tried my best not to move as my sacrum yelled at me.  I remember thinking, maybe something has to be wrong.  I've had stress fractures before, and those were fractures, and none of them hurt like this.  Still, I was thinking maybe I'd torn some of the posterior SI ligaments, maybe I had a little glute and high hamstring tendonitis.  I left the MRI with grandiose plans to get a bunch more Christmas shopping done.  I went to one store, then was grabbing some lunch when my sister's number popped up on my phone.  The instant that I saw she was communicating via phone call instead of text, I could only think, I'm screwed.  Sure enough, the first thing she said to me was, you're basically pretty screwed.  She listed the damage.  A right-sided sacral fracture with associated bone marrow edema and tissue swelling.  Well, that explained a whole ton of things.  A right ischial tuberosity fracture.  That one I could only sort of laugh at, as it was a stress fracture on the same bone on the left that started me in triathlon five years ago.  Who breaks both sides of their ass?  How did that happen again without hitting it on anything?  More swelling there.  A little swelling in my right hip joint and glutes (again, I freaking hit on the left).  Then, the kicker, the cause of that ominous groin pain-a fracture near the ischial/pubic bone junction, on the edge of the acetabulum (hip joint socket).  It didn't look displaced on the MRI, and it didn't look like it was extending into the hip joint space, but, they weren't sure.  I'd need a CT to confirm.  Non-displaced, not into the hip joint-it would heal.  Any displacement or extension into the hip joint, on the other hand, could have meant surgery to piece me back together, or, my worst fear when it comes to anterior hip pain, disruption of blood supply to the femoral head.  I was a bit of a wreck for a couple of days, but luckily, my incredible support system pulled through for me and then some.  The CT eventually confirmed that the joint had been spared-I would be fine.

   Since then, my instructions have been weight-bearing as tolerated, crutches as needed, cleared for the pool (not pushing off) and bike once tolerated, just not clipped in to avoid stressing some of the muscle attachments that pass around the fractured areas.  Upon further consult earlier this week, I learned that my version of "as tolerated" might be a bit higher than it should be.  Progress overall has been slow(er than I'd like), but mostly steady.  I've been given timelines of anywhere from 6-8 weeks to 4-6 months to get back to full training, so my strategy has just been to listen to my body, and accept what it can do, when it can do it.  For someone who's used to being able to push her body day in and day out, dealing with a different sort of pain every single day, almost every time I'm up still does get tiring.  It took me a good three weeks until I was able to sleep through the night without some sort of medication with "PM" in the name.  For a couple of weeks afterwards, I had a completely uncharacteristic lack of appetite, complete with random periods of nausea-which I often solved with the one food that sounded appealing, chocolate chip cookies (hey, it's the holidays.  I was injured, and I like cookies).  The scary anterior hip/groin pain, though, has greatly eased.  For a while, I couldn't actively flex that hip without feeling like I was being stabbed, but now I can lift the leg like a pro (sort of).  The ischial tuberosity fracture bothers me if I sit too long and then stand up, but that's to be expected-been there, handled that.  The biggest remaining issues are the ribs and scapula (which did x-ray negative again, but, then again, my follow-up pelvic x-ray was clear as well-if I was a betting person, I'd put money that I fall into the category of ~50% of rib fractures that don't show on x-ray), and the sacrum.  Every day is a bit of an adventure-what will my sacrum handle today?  Can I move that way?  Can I stand on that leg to put the left into a pair of pants, or should I sit down?

   Workout-wise, I'm doing what I can, which isn't much, but it's something. I'm able to swim (with a buoy, no way I could kick) every other day to rib tolerance.  My sacrum doesn't love rotating, and my ribs burn afterwards, but it still feels good, in some sick way.  I can water run with a belt pretty much to my heart's content, as long as I don't push it too much on the right leg range of motion.  I'm working on whatever core and strength work that I can, as I can already tell that the imbalances are building, and I'm going to be in loads of trouble if I think I can get back into training without proper rehab.  As the orthopedist that I talked to this week told me, it's not just the fractures that I need to worry about; a blow to that area likely caused a whole bunch of damage/tearing to my SI ligaments, which, judging from the way my bones were awkwardly positioned right after the crash, seems like the case.  Luckily, I have plenty of resources in the rehab regard.   I tried biking once-didn't work out so well.  But, although I've been entirely overly dramatic and annoyed at being sick these past couple of days, it might just be the healing impetus I needed to allow me to try biking again.  I'm recovering nicely from my plague, though, so...maybe tomorrow.  It's a new year, after all. :)

   It's more than just about the physical, though, isn't it?  The whole mental/emotional state is just as much of a part of this.  I put my bike back together last week.  The stickers were still on there, the frame was covered in the stickiness of spilled sports drink, the underside of the bar tape had remnants of dried blood on them, dirt from the side of the road coated it in parts.  On the end of the left bars, there was a small scratch, and another bit of scuffing on the back of the seat.  My aerobottle and garmin were the only casualties.  It took me so long to put it back together because frankly, all of that was one giant, painful reminder of it all.  And quite honestly, as positive as I've tried to remain, I do have times where I just get upset about it all.  I get pissed, I get sad, I replay the moment over and over again in my head all while wishing that I could just somehow forget it.  Being active, being competitive, being a part of this sport is a huge part of my life, and to have that taken away, even if just temporarily, is not going to make me happy.  That's being human.  And maybe it's selfish and short-sighted, but I think that sometimes when we're disappointed or upset over something, we need to allow ourselves to feel those emotions and not feel guilty about them just because we could have it far, far worse.  But eventually, it becomes about putting them into perspective, picking up the pieces, and moving forward rather than dwelling on the negative.  Focus on what you can do.

   Still, I know I'm lucky.  If nothing else, this past month has given me a greater appreciation of how healthy I normally am, and how minor my problems actually are.  I just watched a news report about the homeless population in Rochester living in tents under a bridge, and how they're going to be displaced tonight because of the fireworks display-and I'm upset about not being able to ride my multiple thousands of dollars worth of bike sitting in my warm, cozy home.  To be truly disabled, to live every day with chronic pain or degenerative conditions or autoimmune diseases without any real chance of significant improvement-I don't even want to imagine that.  For me, the difference between continuing on with life as I know it vs. a long uphill battle was a fraction of an inch in my hip.  Even more importantly than that, from what I can figure out from the bike damage (or lack thereof), the bike might have flipped.  So, I could easily have landed another six inches up on my head or neck, which again falls into the "I don't want to imagine that" category.  As my neighbor had said last week as we exchanged Christmas cookies at the front door, "look at poor Mike Coyle, he never had a chance".  Whenever I drive from the chiropractor to work up 250, I see a roadside memorial just before I get into Webster.  Not a day passes where I haven't thought of these losses.  I'm still here right now, with all of the most important stuff intact.  And, as I've said before, this stuff happens in our sport.  It's the risk we take, and I'd been extremely lucky in that regard up until this point.  Just part of the game.  So, overall I've been good mentally.  I had the holidays and all of the associated baking, shopping (mostly done before I knew that I shouldn't be walking so much...), wrapping, and family time to enjoy, so I was overall fulfilled in different ways and happy from all of that.  Having some time to spend with those most important to me is more valuable than any training session or race.

   Plus, I've been injured more times than I can remember in my past.  I'll be able to swim and bike fairly normally soon, and I know that I can maintain reasonable running fitness based on that alone.  It was 12 weeks off of running for an ischial tuberosity fracture that got me into triathlon in the first place, after all, and I really wasn't that far off running-wise in my first race, despite the fact that I think I ran about 4 times, for a grand total of 12 miles, heading in.  It's just been a while since I was sidelined from injury.  In the past 5.5 years, I think that I've maybe missed 4-5 runs and a recovery ride due to pain.  That's not a bad recent history for someone who never used to be able to make it more than a month or two without some stress fracture of tendinopathy.  One way or another, I made it through to the other side; the only difference this time is that I went from healthy to broken a bit more quickly and dramatically.  At the end of it all, I think I stand to gain more than I've lost from this.  When I was sitting in the hospital with Dave, even before x-rays, I turned to him and said, wouldn't it be ironic if I broke pelvis, and all I could do is swim for a while after I was complaining so much about swimming recently?  In some way, I'm still convinced this was all one big ploy by those swim gods.  In reality, though, having my strong suit taken away and thus being forced to work on my weakness is one heck of a blessing in disguise.  I was truly dreading every last swim towards the end of last season; I had lost any sort of pleasure in it whatsoever.  But now, I'm so darn grateful to be able to do anything that the pool has become far more tolerable (for now).  Maybe more importantly, I now have bit of a score to settle, a chip on my shoulder, an albatross around my neck.  For a while, I was too concerned with bigger issues to worry about my fitness, and I won't be able to go gung-ho for a bit, but I'm starting to feel a bit like I'm just waiting to pour some gasoline on the flickering flame.  I've also learned how truly awesome those that are around me are, and I've appreciated every person who reached out to me in any way, shape, or form.  I don't know exactly what the new year will bring, but I'm glad to be moving forward with new opportunities and challenges coming my way!

   Also, I should add that outside of races, life this past year was actually pretty freaking good.  I changed jobs and found more opportunity in that regard.  I was able to commit more of myself to training, and to all of the other stuff that goes along with it.  Coaching with VTP was hugely rewarding, and I'm very thankful for that position and to those who have allowed me to be a part of their journeys.  I know it sounds cliched, but I watched some dreams be realized out there, and I felt the warm fuzzies from all of that.  I spent time with my family and friends, and I'm continually grateful to be able to have those opportunities.  I'm getting to watch my niece and nephews grow up and develop their own little personalities (and quirks).  I traveled some cool places, and was able to again see family and friends in many of those locations.  It might sound somewhat inconsequential, but I was able to get to the woods with my dogs more regularly-there's something extremely therapeutic about watching them enjoy the pure exuberance of movement while the seasons changed around us.  I did some of my best thinking, planning, analyzing, and dreaming in those woods.  I met new people, made new friends, and, if this whole thing was going to convince me of anything, it's that I pretty much have the greatest support system, both near and far, that anyone could possibly ask for.  So, life remained good as a whole.  Still, here's to the new year, new health, and continuing to look forward!

Inspirational comeback picture exhibit A: Johnny's Running of the Green 2006.  My first race back after an extended period of time off from a stress fracture. I performed respectably.  Also,let it be noted that I was freshly dating Dave, and I dragged him out to this.  I was planting the seeds of creating the monster.

Still Johnny's, I just wanted to include the "cooling down with Carolynne" shot.  This happened every year at that race.

Exhibit B: Fall 2006, after our conference XC meet with my friend/teammate/fellow fifth year senior Kate.  I missed like, seven months of training with knee and ITB problems.  I started the season in hideous shape.  I'm clearly not at race weight.  But, I managed to sneak onto the scoring team (I was like, 85th place overall, but whatever) here, and ran (bringing up the back of the pack) at Regionals.  It was still some of the most hugely rewarding slow racing I've ever done.

Exhibit C: Spring track 2007, Hillsdale Gina Relays 5k.  After that XC season, I promptly started to get back into shape, and ran myself into another stress fracture that winter.  Oops.  A former teammate made some comment to me about how I was done.  I got annoyed by that, and then water ran, biked, and ellipticaled like a madwoman.  This was my third race back; I'd been running for maybe a month.  I dropped ~40sec from the 5k I had run the week before, and I surprised myself by running 18:17, within 10sec of my PR.  Again, nothing special in the world of D1 track, but I couldn't have cared less that evening.  After a year of struggles, this race was easily one of the highlights of my collegiate track career.
2009 Cape Cod vacation with my mom and sister.  This was in the midst of my 3 month hiatus from running thanks to ass fracture #1.  I was biking and swimming, though, and even without running, I somehow managed to enjoy this beautiful night with a fantastic sunset on an awesome beach with family.  Life was good, broken ass and all.
Some memorabilia from my first tri, about a month later (that's an AG award, I didn't win the whole thing).  I think this might be the only race photo that I've ever actually purchased for myself, but I secretly really like having it.  I'm heading out onto the 10k run, after not having run that far in about four months.  My mom said I looked "hopeful" in that picture, which I like more than, "like you're thinking wtf".  This race will always be one of the highlights of my tri career, though, and not just because it was my first, but because it represented another time where I had made the most of what I could do during an injury, and I had opened a HUGE new door as a result.

Time out from positiveness to display this bastard of a Chinese food fortune, that mocked my gimpy state.

That's better.

The annual, "Merry Christmas, we have dogs and do triathlon" shot.  Bonus points if anyone can detect the theme of the triathlon items behind the dogs.


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